'Windshield Wiper Technique' for AcromioclavicularJoint Resection

摘要

Acromioclavicular (AC) joint pain secondary to arthritis, osteolysis, and intra-articular injury to the disc of the AC joint is a common cause of shoulder symptoms. For cases refractory to conservative treatment, both open and arthroscopic AC joint resections have been established. Open AC joint resection requires extensive tissue dissection and can result in postoperative shoulder muscle weakness, delayed rehabilitation, and additional scarring. Arthroscopic procedures, including both the direct superior approach and the indirect bursal approach, are also associated with postoperative pain. This is because of inadequate or overzealous resection of AC joint; or is because of joint instability from the impairment of the AC joint capsular ligaments. We present a novel arthroscopic technique termed the "Windshield Wiper Technique" for precise and even AC joint resection. Using a direct trans-AC joint portal, this technique allows for uniform resection of the distal clavicle and acromial facet of AC joint. Furthermore, this approach achieves reliably about 5.0 to 7.0mm of bony resection while preserving the ligaments which stabilize the AC joint.