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Patient outcomes following arthroscopic distal clavicle excision: a prospective case series

BACKGROUND: Distal clavicle excision for acromioclavicular joint (ACJ) pathology is currently the mainstay of surgical management in patients with symptoms refractory to nonoperative treatment. There have been few high quality studies outlining the efficacy of arthroscopic excision of the distal cla...

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Autores principales: Leon, Johanna V., Hermans, Deborah, Venkatesha, Venkatesha, Duckworth, David G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10638592/
https://www.ncbi.nlm.nih.gov/pubmed/37969502
http://dx.doi.org/10.1016/j.jseint.2023.07.014
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author Leon, Johanna V.
Hermans, Deborah
Venkatesha, Venkatesha
Duckworth, David G.
author_facet Leon, Johanna V.
Hermans, Deborah
Venkatesha, Venkatesha
Duckworth, David G.
author_sort Leon, Johanna V.
collection PubMed
description BACKGROUND: Distal clavicle excision for acromioclavicular joint (ACJ) pathology is currently the mainstay of surgical management in patients with symptoms refractory to nonoperative treatment. There have been few high quality studies outlining the efficacy of arthroscopic excision of the distal clavicle as a single procedure in patients with isolated disease. AIM: To characterize function and pain outcomes in patients undergoing arthroscopic distal clavicle excision by utilizing stringent inclusion criteria to isolate ACJ pathology. METHODS: Prospective data collection was undertaken with a minimum two year follow-up of 59 patients undergoing arthroscopic distal clavicle excision for ACJ osteoarthritis or distal clavicle osteolysis. Stringent eligibility criteria were applied to each patient. Data collection consisted of demographic data, clinical assessment of range of motion, and patient-reported outcome measures (PROMs), utilizing the standardized Shoulder Pain and Disability Index (SPADI) and the Visual Analogue (VAS) score to characterize pain. Furthermore, time to return to work and sport and a subjective measure of how ‘normal’ the shoulder felt were assessed. Data was recorded preoperatively, and at six, 12, and 24 months postoperatively. Statistical analysis was conducted utilizing institutional support. RESULTS: Statistically significant improvements in range of motion measurements (abduction, forward elevation and external rotation), and PROMs (SPADI and VAS scores) were reported. VAS scores reduced from an average of 8.20 preoperatively to 3.39 (P < .001), 2.13 (P < .001) and 1.36 (P < .001) at 6, 12, and 24 month follow-up, respectively. Similarly, SPADI scores reduced from an average of 62.65 preoperatively to 19.96 (P < .001), 12.6 (P < .001), and 6.13 (P < .001) at 6, 12, and 24 months, respectively. The majority of patients were able to return to sport and work, within an average time of 1.72 and 3.02 months. CONCLUSION: In patients who presented with isolated ACJ pathology, arthroscopic distal clavicle excision, as a single procedure, results in statistically significant improvements in PROMs and functional outcomes.
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spelling pubmed-106385922023-11-15 Patient outcomes following arthroscopic distal clavicle excision: a prospective case series Leon, Johanna V. Hermans, Deborah Venkatesha, Venkatesha Duckworth, David G. JSES Int Shoulder BACKGROUND: Distal clavicle excision for acromioclavicular joint (ACJ) pathology is currently the mainstay of surgical management in patients with symptoms refractory to nonoperative treatment. There have been few high quality studies outlining the efficacy of arthroscopic excision of the distal clavicle as a single procedure in patients with isolated disease. AIM: To characterize function and pain outcomes in patients undergoing arthroscopic distal clavicle excision by utilizing stringent inclusion criteria to isolate ACJ pathology. METHODS: Prospective data collection was undertaken with a minimum two year follow-up of 59 patients undergoing arthroscopic distal clavicle excision for ACJ osteoarthritis or distal clavicle osteolysis. Stringent eligibility criteria were applied to each patient. Data collection consisted of demographic data, clinical assessment of range of motion, and patient-reported outcome measures (PROMs), utilizing the standardized Shoulder Pain and Disability Index (SPADI) and the Visual Analogue (VAS) score to characterize pain. Furthermore, time to return to work and sport and a subjective measure of how ‘normal’ the shoulder felt were assessed. Data was recorded preoperatively, and at six, 12, and 24 months postoperatively. Statistical analysis was conducted utilizing institutional support. RESULTS: Statistically significant improvements in range of motion measurements (abduction, forward elevation and external rotation), and PROMs (SPADI and VAS scores) were reported. VAS scores reduced from an average of 8.20 preoperatively to 3.39 (P < .001), 2.13 (P < .001) and 1.36 (P < .001) at 6, 12, and 24 month follow-up, respectively. Similarly, SPADI scores reduced from an average of 62.65 preoperatively to 19.96 (P < .001), 12.6 (P < .001), and 6.13 (P < .001) at 6, 12, and 24 months, respectively. The majority of patients were able to return to sport and work, within an average time of 1.72 and 3.02 months. CONCLUSION: In patients who presented with isolated ACJ pathology, arthroscopic distal clavicle excision, as a single procedure, results in statistically significant improvements in PROMs and functional outcomes. Elsevier 2023-08-07 /pmc/articles/PMC10638592/ /pubmed/37969502 http://dx.doi.org/10.1016/j.jseint.2023.07.014 Text en © 2023 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Shoulder
Leon, Johanna V.
Hermans, Deborah
Venkatesha, Venkatesha
Duckworth, David G.
Patient outcomes following arthroscopic distal clavicle excision: a prospective case series
title Patient outcomes following arthroscopic distal clavicle excision: a prospective case series
title_full Patient outcomes following arthroscopic distal clavicle excision: a prospective case series
title_fullStr Patient outcomes following arthroscopic distal clavicle excision: a prospective case series
title_full_unstemmed Patient outcomes following arthroscopic distal clavicle excision: a prospective case series
title_short Patient outcomes following arthroscopic distal clavicle excision: a prospective case series
title_sort patient outcomes following arthroscopic distal clavicle excision: a prospective case series
topic Shoulder
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10638592/
https://www.ncbi.nlm.nih.gov/pubmed/37969502
http://dx.doi.org/10.1016/j.jseint.2023.07.014
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