Update on indications and surgical techniques for acromioclavicular joint resection

Background Osteoarthritis of the acromioclavicular (AC) joint is a typical cause of anterior-superior shoulder pain. In case of persisting symptoms of the degenerative AC joint and after failure of conservative therapy, arthroscopic or open AC joint resection can be considered. Materials and methods The present review is based on a selective literature search (PubMed, Medline, Google Scholar). All German- and English-language publications of the last 15 years considering both arthroscopic and open procedures were included. Results Throughout the current literature, an increasing number of studies recommends arthroscopic bipolar (clavicular and acromial) resection in case of indication for surgical therapy. However, significant clinical differences of functional outcomes following arthroscopic and open resection of the AC joint have not be proven so far. The recommended extent of resection should be 6-8 mm and should not exceed 10 mm to prevent relevant AC joint destabilization. Conclusions In case of persistent pain and failure of conservative therapy, arthroscopic bipolar AC joint resection represents the standard surgical treatment of first choice. Open AC joint resection appears rarely indicated and necessary.