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Arthroscopic Distal Clavicle Resection of Symptomatic Acromioclavicular Joint Arthritis Combined with Rotator Cuff Tear. Prospective Randomized Trial

      Introduction

      To compare the clinical results between those who had distal clavicle resection (DCR) and those who did not during RC repair.

      Methods

      From August 2008 to December 2009, 58 shoulders were included. All patients had RC tears, as well as ACJ tenderness and radiologic arthritis. They were randomized into two groups: DCR and RC repair versus RC repair only group. The indications for DCR included at least grade II tenderness at the ACJ (on a scale of 0, I, II, and III), an arthritic change visible on simple X-rays (Grade II-III, in accordance with Peterson), and a positive ACJ lidocaine injection test (the day before surgery). The clinical assessment was performed, examining ACJ tenderness, the American Shoulder and Elbow Surgeons (ASES) score, the Constant shoulder score, and pain Visual Analog Scale (VAS) score.

      Results

      After simple randomization, 26 shoulders were allocated in the DCR group, and 32 were placed in the No DCR (isolated RCR) group. The final evaluation was performed for 21 shoulders in DCR group and 26 shoulders in the isolated RCR group. The mean follow-up period was 44.2 months in the DCR group and 44.0 months in the isolated RCR group. There were no differences in age, sex, symptom duration, and preoperative ASES score, Constant score, pVAS score, and rotator cuff tear size between two groups. (P>.05) The ASES, Constant, and pVAS were significantly improved in both groups, respectively. (P

      Conclusion

      There was no difference in the clinical evaluations between the combined arthroscopic DCR and RCR group and the isolated RCR group at minimum 2 year follow-up. Arthroscopic DCR should be carefully considered in patients who have symptomatic ACJ arthritis with RC tear.