Acromioclavicular joint arthroscopy and debridement

Degenerative acromioclavicular (AC) joint pathology is common in middle-aged and elderly patients, and there have been good reported results after excision of the distal clavicle either as an open or arthroscopic procedure. There is a small population of young patients, however, who present, often after injury, with AC joint-related pain but with normal imaging and no evidence of instability. This population of patients poses a difficult management problem as excision of the distal clavicle is difficult to justify at such a young age and can potentially lead to symptoms from increased anteroposterior instability.Arthroscopy of the AC joint with debridement of the damaged meniscus and articular surfaces is a potential alternative. The technique of direct AC joint arthroscopy and debridement involves anterior and posterior portals, with direct visualization and debridement of pathology within the AC joint, in particular the meniscus. Follow-up of 14 patients with this procedure demonstrated satisfactory relief of pain in 11 patients.