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One Plus One Equals Relief of Shoulder Pain

Some patients with shoulder problems end up needing two different procedures to relieve their pain and return their range of motion. Arthroscopic subacromial decompression involves relieving pressure underneath the acromion (the top part of the shoulder blade). Arthroscopic resection of the clavicle (collarbone) involves taking off the end of the clavicle to relieve pain in the acromioclavicular (AC) joint. The AC joint is where the clavicle and acromion meet.

Both procedures have been proven effective when they are done separately. These authors did both procedures at the same time. They performed 32 surgeries in 31 patients. The authors followed up with the patients an average of five years after surgery. All patients were satisfied with their surgery. Only five patients had even mild or occasional pain, and that was only with strenuous overhead activities. Strength and motion tests showed no significant difference between the patients' healthy shoulders and the shoulders that had surgery.

Before their injuries, 25 of the patients had been involved in sports, including four professional athletes. Significantly, 22 of the 25 returned to their previous level of play, including the four professionals.

The authors conclude that the two procedures are safe and effective when done together. And results using the arthroscope were as good as surgeries using an open approach. That's good news for the group of patients that need both procedures to return their shoulders to full strength. Arthroscopic surgery is done using a small fiber-optic TV camera so surgeons can see the area they are working on. The arthroscope allows much smaller incisions. An open approach requires a longer incision and tends to disrupt the muscles around the shoulder.

References: Scott David Martin, MD, et al. Arthroscopic Resection of the Distal Aspect of the Clavicle with Concomitant Subacromial Decompression. In The Journal of Bone and Joint Surgery. March 2001. Vol. 83-A. No. 3. Pp. 328-335.

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