Distal Clavicle Excision (Resection)

October 5, 2017

Impingement syndrome and associated rotator cuff tears are commonly encountered shoulder problems. This condition is caused when the rotator cuff tendons rub the underside of the acromion bone. Chronic rubbing can lead to a weakening and even tearing of the rotator cuff. Symptoms include pain, weakness and loss of motion. Whether this procedure is done using a scope or through a small incision is dependent on the severity of the tear and the doctor’s preference. The method shown in these animations is with a scope.

One of the most common problems causing shoulder pain is known as bursitis. Bursitis consists of chronic inflammation of the gliding tissue (bursa) that protects the rotator cuff tendons from rubbing against the undersurface of the bone. Adding to the problem, a bone spur may develop on the undersurface of the acromion which reduces the space in which the rotator cuff tendons can glide.

Small incisions (portals) are made around the joint. The scope and surgical instruments will go into these incisions.

The scope is inserted into the back of the shoulder joint. Saline solution flows through a tube (cannula) and into the bursa sac to expand the joint and to improve visualization. The image is sent to a video monitor where the surgeon can see inside the joint.

A specialized surgical instrument is used to remove the inflamed and irritated bursa sac. A surgical bur is used to remove bone and bone spurs from the underside of the acromion and clavicle. More space is created for the rotator cuff tendons.

In the case of an arthritic AC joint some of the bone is removed from the end of the clavicle to create more space.

Following the procedure, patients should expect to be in a sling for 5-7 days until the incisions are healed. Physical therapy may be recommended by your physician to restore motion and strength to your arm and shoulder. A full recovery may take 2-3 months.