Abstract
With widely reported co-existence of impingement syndrome and acromioclavicular joint (ACJ) disease, some surgeons recommend that ACJ resection be combined with subacromial decompression.
From 1998 to 2003, 201 patients with symptomatic ACJs were taken to theatre. Bursoscopy was performed on 129 males and 54 females, those patients who had previously undergone ipsilateral shoulder surgery or had sonographically-proven rotator cuff tears being excluded. The mean age was 41 years (16 to 72). The preoperative diagnosis was isolated ACJ disease in 136 patients and combined ACJ disease and impingement in 47. Bursoscopy revealed no abnormalities in 124 of the 136 patients in whom isolated ACJ disease was diagnosed. In two patients, minimal bursal fraying was noted but no decompression was performed. Significant ‘impingement lesions’ were seen in 10 patients, all of whom were over age 35 years.
Symptomatic ACJ disease coexisted with impingement (lesion or signs) in only 57 of 183 patients (31%) patients. With careful preoperative evaluation, unnecessary surgery is avoidable.
Secretary: Dr H.J.S. Colyn, Editor: Professor M.B.E. Sweet. Correspondence should be addressed to SAOA, Box 47363, Parklands, Johannesburg, 2121, South Africa.
