gms | German Medical Science

54. Jahrestagung der Norddeutschen Orthopädenvereinigung e. V.

Norddeutsche Orthopädenvereinigung

16.06. bis 18.06.2005, Hamburg

The role of the AC joint with arthroscopic subacromial decompression – coplaning or resection of the distal clavicle?

Meeting Abstract

  • corresponding author R. Heikenfeld - Klinik für Orthopädie am Institut für Radiologie und Mikrotherapie, Universität Witten/Herdecke, St. Anna Hospital Herne, Herne
  • R. Listringhaus - Herne
  • G. Godolias - Herne

Norddeutsche Orthopädenvereinigung. 54. Jahrestagung der Norddeutschen Orthopädenvereinigung e.V.. Hamburg, 16.-18.06.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05novEP30

The electronic version of this article is the complete one and can be found online at:

Published: June 13, 2005

© 2005 Heikenfeld et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.




The arthroscopic subacromial decompression is a standard procedure for subacromial impingement. Arthroskopic therapy of a symptomatic AC joint arthritis with resection of the distal clavicle is a common procedure. Borderline cases can be difficult to treat.


537 shoulders, operated 2000 - 2001, with impingement and radiographic signs of a AC arthritis, were included into this study. Excluded were shoulders with partial or full thickness tears of the rotator cuff or glenohumeral chondromalacy greater than 2°.


451 shoulders were evaluated. In all cases a arthroscopic bursectomy and acromioplasty was performed. All cases showed arthroskopic osteophytes on the acromial and clavicular side. Besides the resection of osteophytes the discus articularis was partially removed. In 72 cases, that had only pain from the AC joint on examination and were painfree after a i.a. injektion of bubivacain, an additional resection of the distal clavicle was performed. In 26 shoulders a secondary resection of the distal clavicle was necessary that were treated by coplaning initially. The Constant Score showed no significant differences between these 3 groups at follow up.


In situations with subacromial impingement and present AC Arthrosis the resection of osteophytes with an AC joint debridement gives satisfying results. If the AC arthrosis is the single cause of pain, a resection of the distal clavicle should be considered. In case a secondary arthroscopic resection of the distal clavicle is necessary, the final result can be equal to a primary procedure, but the risks of a second procedure have to be considered.