Treatments of Chronic Acromioclavicular joint dislocation are controversial. Many procedures have been described in the past for the management of them. Treatment modalities have changed with increasing understanding of the nature of the problem, patient expectations and the biomechanics of the joint. Aim. To assess the functional outcome of the chronic AC joint dislocations treated by modified Weaver-Dunn procedure combined with Acromioclavicular joint augmentation. Material and methods. We treated 54 patients with chronic AC joint dislocation by modified Weaver-Dunn procedure with additional AC joint augmentation. We used tight rope system in 20 patients, Mersilene tape in 22 patients and no 5 Ethibond in 12 patients. Results. This Study was done between Jan 2003 to Jan 2012. Mean follow up was 20 months, mean age of the patients was 35, and male to female distribution was 48:6. We assessed them clinically and radio logically during their follow up. All patients were back to their occupation. 80% are back to their pre injury sporting activity level. The mean Disabilities of the Arm, Shoulder, and Hand (DASH) score was 10.2 points. One patient had a failure of augmentation device. Conclusion. Our study shows that chronic symptomatic AC joint dislocations, (Rockwood types III to V) Managed with modified modified Weaver-Dunn procedure with augmentation are showing good short term results. Significant improvement in the patient satisfaction, early return to work and radiological appearance

Treatments of Chronic Acromioclavicular joint dislocation are controversial. Many procedures have been described in the past for the management of them. Treatment modalities have changed with increasing understanding of the nature of the problem, patient expectations and the biomechanics of the joint. To assess the functional outcome of the chronic AC joint dislocations treated by modified Weaver-Dunn procedure combined with Acromioclavicular joint augmentation. We treated 54 patients with chronic AC joint dislocation by modified Weaver-Dunn procedure with additional AC joint augmentation. We used tight rope system in 20 patients, Mersilene tape in 22 patients and no 5 Ethibond in 12 patients. This Study was done between Jan 2003 to Jan2012. Mean follow up was 20 months, mean age of the patients was 35, and male to female distribution was 48:6. We assessed them clinically and radio logically during their follow up. All patients were back to their occupation. 80% are back to their pre injury sporting activity level. The mean Disabilities of the Arm, Shoulder, and Hand (DASH) score was 10.2 points. One patient had a failure of augmentation device. Our study shows that chronic symptomatic AC joint dislocations, (Rockwood types III to V,) Managed with modified modified Weaver-Dunn procedure with augmentation are showing good short term results. Significant improvement in the patient satisfaction, early return to work and radiological appearance

The aim of our study was to assess, for the first time in a large study, whether there are radiological features of the acromioclavicular joint (ACJ) which vary with age or between genders and side. Clinical experience suggested that there was no clear correlation between the radiological features and symptoms arising from the ACJ. Therefore we also aimed to test the null hypothesis that there are no consistent radiological features which correspond with the need for surgical excision of the ACJ. We analysed 240 shoulder radiographs, divided into male and female, left and right shoulders, and decades from 20 to 80 years inclusive. At the ACJ the presence of sclerosis, osteophytes, cysts and lysis were recorded, and the width of the joint measured. These same parameters were assessed on the pre-operative radiographs for a group of 100 patients by a blinded observer. Fifty had undergone ASD (arthroscopic subacromial decompression), and 50 ASD with ACJ excision. These two groups were age matched. Statistical analyses were performed. There was no statistical difference between any of the parameters for gender or side however with increasing age there was a significantly increased incidence of joint space narrowing and increased features of osteoarthrosis. When comparing the matched ASD and the ACJ excision groups it was found that the presence of medial sclerosis (p = 0.016) and superior clavicular osteophytes (p = 0.016) were more common in the ACJ excision group. We concluded that there is a change in the radiological features of the ACJ with increasing age but not between sides or gender. The null hypothesis is upheld. Only 2 parameters, namely medial acromial sclerosis and superior clavicular osteophytes, are radiological features which correlate with a symptomatic acromioclavicular joint. These have poor sensitivity and specificity and therefore should not be used as a test

Acromioclavicular joint injuries are one of the most common injuries in the shoulder girdle complex. Surgical management is considered based on patient profile, level of activity, pain, and classification of injury. To date, a vast array of surgical techniques have been proposed and described in the literature, a possible reason being that the optimal solution is still uncertain. The aim of this study is to determine the efficacy of an alternative surgical technique. This study is a retrospective case series of 80 patients that have been operated by a single surgeon over a period of 6 years. A novel surgical technique, the ‘BiPOD method’, was applied where a synthetic artificial ligament (LARS®) is used to reconstruct and reduce the acromioclavicular joint. The technique is done in a reproducible manner, where a single continuous artificial ligament is used to reduce and reconstruct both, the coracoclavicular and acromioclavicular ligament complexes to achieve bidirectional stability. Patients were followed-up postoperatively, either clinically where possible or telephonically. The Acromioclavicular Joint Instability Score (ACJI) and radiographic measurements were used to determine the clinical and surgical outcome of the surgery. Radiographic parameters, measuring the reduction of the coracoclavicular- and acromioclavicular joint, were analysed and documented. The results showed marked improvement in both, the coracoclavicular distance and acromioclavicular distance. Clinically, using the ACJI scoring system, the patients reported substantial improvement in pain and function. Complications were recorded but were insignificant. The BiPOD surgical technique, making use of an artificial LARS® ligament, has proven acceptable outcomes in the surgical management of acromioclavicular joint dislocations

Acromioclavicular joint is an integral component of Shoulder Complex and common site of injury particularly for athletes involved in sports such as Football, Cricket, Rugby and Shotput. Acromioclavicular Injuries are often neglected and goes untreated especially in low demand patients. Classic surgical techniques are associated with high complication rates. This is a prospective study from 2015–2017 wherein 32 patients with Acute grade 3, 4, 5, 6 Acromioclavicular joint dislocations, were operated with Minimally Invasive Double Tunnel Anatomical Coraco-clavicular Ligament Reconstruction (DT-ACCLR) with Tightrope Suspensory fixation. Clinical Outcomes were evaluated with Visual Analog Scale, Constant functional scale, Start of Movement, Return to Work, Satisfaction index and Coraco-clavicular distance over 12 months. Mean follow-up was 14 ± 3.8 months. Visual analog scale and Constant scores revealed significant advancements 0 ± 0.5 (range, 0–2) and 95 ± 3 (range, 92–98) scores at 12 months respectively. The coraco-clavicular distance significantly reduced from 23 ± 2.4 mm to 8 ± 0.5 mm. Mean return to work by 7 days. 98.6% patients were satisfied with surgical results. We conclude that DT-ACCLR is simple and creative surgical technique which provides stable, reliable and painless AC joint. The patients can move the shoulder same day and return to Work by 5–7days and Sports 3–4 weeks

Acromioclavicular joint (ACJ) dislocations is a common disorder amongst our population for which numerous techniques have been described. It is thought that by using this novel technique combining a CC and AC repair with a reconstruction will result in high maintenance of anatomical reduction and functional results. 12 consecutive patients ACJ dislocations were included. An open superior clavicular approach is used. Firstly, the CC ligaments are repaired after which a CC reconstruction is performed using a tendon allograft. Secondly, the AC ligaments are repaired using an internal brace construct combined with a tendon allograft reconstruction (Figure 1). The acute:chronic ratio was 6:6. Only IIIB, IV and V AC-joint dislocations were included. The Constant-Murley Score improved from 27.6 (8.0 – 56.5) up to 61.5 (42.0 – 92.0) at 12 months of follow up. Besides one frozen shoulder from which the patient recovered spontaneously no complications were observed with this technique. The CCD was reduced from 18.7 mm (13.0 – 24.0) to 10.0 mm (6.0 – 16.0) and 10.5 mm (8.0 – 14.0) respectively 12 weeks and 12 months postoperatively. There is some evidence, suggesting to address as well as the vertical (coracoclavicular (CC) ligaments) as the horizontal (acromioclavicular (AC) ligaments) direction of instability. This study supports addressing both entities however comparative studies discriminating chronic as acute cases should be conducted to further clarify this ongoing debate on treating ACJ instability. This study describes a novel technique to treat acute and chronic Rockwood stage IIIB – IV ACJ dislocations with promising short-term clinical and radiological results. This suggests that the combined repair and reconstruction of the AC and CC ligaments is a safe procedure with low complication risk in experienced hands. Addressing the vertical as well as horizontal stability in ACJ dislocation is considered key to accomplish optimal long-term results

The treatment of Grade III acromioclavicular joint (ACJ) dislocations has been a subject of much controversy, even as early as Hippocrates. We hypothesized that this surgical technique would improve patient functional outcome. Methods and Results. We present a case series of 17 patients all of whom have had grade III dislocations of the ACJ. The patient population was young active adults. Surgery was performed within four weeks in all cases. One Surgeon in the Queen Elizabeth hospital, University of Birmingham, performed the same procedure on all 17 patients. A standard technique was used for tight rope fixation. The fixation device is comprised of no. 5 fibrewire suture and 2 metal buttons, joined by a continuous loop. This is a low-profile double-metallic button technique. Postoperatively all patients remained in a polysling for three weeks and postoperative rehabilitation was commenced after that point including physiotherapy supervised pendular exercises and gentle passive movements. They were all seen six weeks and three months post operatively. Clinical and radiographic assessment was performed to assess the fixation. Of our cohort of patients, one required revision open stabilization after sustaining a mechanical fall on the affected operated side. There was a failure of fixation in a patient who was non-compliant with postoperative instructions. At three months postoperatively all patients were satisfied with the functional outcome and were able to return to pre injury level of activity. Bar the two failures the average OSS was 45.2 (range 40–48). 14 patients returned to their pre injury occupation and sports fitness. Conclusion. This technique provides a simple, reproducible, minimally invasive technique for acute ACJ dislocation, which expedites a functional recovery of this acute injury. It is a non-rigid fixation of the AC joint that maintains reduction yet allowing for normal movement at the joint

Introduction. We present an all arthroscopic technique for modified Weaver Dunn reconstruction of symptomatic chronic type III acromioclavicular joint injuries. Method. Over a 1 year period we performed 12 all arthroscopic modified Weaver-Dunn procedures. All patients had failed non-operative management for at least 6 months, with symptoms of pain and difficulty with overhead activities. The technique involved excision of the lateral end of clavicle, stabilisation with a suture cerclage technique from 2 anchors placed in the base of the coracoid and coracoacromial ligament transfer from the acromion to lateral end of clavicle. The technique is identical to our open technique and those published previously by Imhoff. Post-operatively the patients were immobilised for six weeks, followed by an active rehabilitation programme and return to work and sports at 3 months. Results. We have currently performed this technique in 12 patients, all male. The average age at operation was 25.8yrs at a mean interval of 11 months post-injury. The mean Constant score pre-operatively was 49 (44-54). The mean 3 month post-operative Constant score was 88.6 (84-96). There have been no complications, and the 2 professional sportsmen within our cohort returned to full contact at 3 months. Due to an irreducible clavicle, one patient required an open excision of lateral clavicle, with the rest of the procedure performed arthroscopically. Discussion. Arthroscopic Weaver-Dunn has a number of advantages over the corresponding open procedure. It avoids the detachment of deltoid needed to gain exposure and also the morbidity from the wound. From our experience it enables patients to regain their function more rapidly with an earlier return to sporting activities. Conclusion. The early results from our initial experience have been excellent, with no complications. With this technique an anatomic reconstruction can be achieved with excellent cosmesis, low morbidity and potentially accelerated rehabilitation

This study aimed to describe the morphology of the coracoid process and determine the frequency of commonly observed patterns. The second purpose was to determine the location of inferior tunnel exit with superior based tunnel drilling and the superior tunnel exit with inferior based tunnel drilling.

A sample of 100 dry scapulae for the morphology aspect and 52 cadaveric embalmed shoulders for tunnel drilling were used. The coracoid process was described qualitatively and categorized into 6 different shapes. A transcoracoid tunnel was drilled at the centre of the base. Twenty-six shoulders were used for the superior-inferior tunnel drilling approach and 26 for the inferior-superior tunnel drilling approach. The distances to the margins of the coracoid process, from both the entry and exit points of the tunnel, were measured.

Eight coracoid processes were of convex shape, 31 of hooked shape, 18 of irregular shape, 18 of narrow shape, 25 of straight shape, and 13 of wide shape. The mean difference for the distances between superior entry and inferior exit from the apex was Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation 3.65+3.51mm (p=0.002); 1.57+2.27mm for the lateral border (p=0.40) and 5.53+3.45mm for the medial border (p=0.001). The mean difference for the distances between inferior entry and superior exit from the apex was 16.95+3.11mm (p=0.0001); 6.51+3.2mm for the lateral border (p=0.40) and 1.03+2.32 mm for the medial border (p=0.045).

The most common coracoid process shape observed was a hooked pattern. Both superior to inferior and inferior to superior tunnel drilling directed the tunnel from a more anterior and medial entry to a posterior-lateral exit. Superior to inferior drilling resulted in a more posteriorly angled tunnel. With inferior to superior tunnel drilling cortical breaks were observed at the inferior and medial margin of the tunnel.

We present 2 year results of a prospective natural history study of Type III Acromioclaviclular joint dislocation (ACJD) treated non-operatively. Previous natural history studies are compromised by inconsistent definitions of the grade of injury and non-validated scoring tools; they do not identify which patients will have ongoing symptoms. This trial documents the strength and subjective recovery over time, and identifies risk factors for poor outcome and need for surgery.

Patients with Rockwood Type III ACJD received a standardised rehabilitation protocol (6 sessions of physiotherapy). Clinical assessment was performed at presentation, 3, 6, 12 and 24 months after injury, including isometric strength testing, pain (VAS/10) and subjective scores – Subjective percentage of normal (SPON), American Shoulder and Elbow (ASES), Oxford Shoulder Score (OSS) and Quick Disabilities of Arm Shoulder and Hand (qDASH).

28 male patients were recruited, 26 reached 12, and 9 to 24 months follow up. Two required surgery and one emigrated. The mean age was 39 (15 to 67). Initial mean pain was 3/10, SPON 51% (6–95) and strength was 76% of the other side. By 3 months mean subjective recovery was 70% and strength 90%. Strength recovered to 99% of normal by 12 months but subjective scores remained at mean 90%; by 24 months subjective scores were mean 94%. 2 patients had subjective scores <80%.

There was a wide range of initial subjective scores and weakness after Type III ACJD. 95% of strength had recovered by 6 months and subjective scores recovered to 94% of normal by 24 months. 4 patients (14%) did poorly with 2 requiring surgery. Low initial subjective score and inability to abduct the arm at presentation were risk factors for a poor outcome.

Osteolysis has been reported following ACJ reconstruction with a synthetic graft. We present the first study into its prevalence and pattern, and its effect on patient outcome.

Patients who underwent treatment of an unstable ACJ injury using the Surgilig/LockDown implant were identified via our database. Patients were invited to attend a dedicated outpatient clinic for clinical examination, radiographic evaluation, and completion of outcome scoring. Patients who were unable to attend were contacted by telephone.

49 patients were identified. We assessed 21 clinically at a mean of 7 years post-procedure (range 3–11 years). All had radiographic evidence of distal clavicle and coracoid osteolysis. We did not observe progression of osteolysis from the final post-operative radiographs. A further 13 were contacted by phone. The mean Oxford Shoulder Score was 43 (range 31–48) and mean DASH score was 8.5 (range 3–71). The average Patient Global Impression of Change score was 6 (range 2–7). Six patients underwent removal of a prominent screw at a mean of 2 years after surgery; the pattern of osteolysis was no different in this group. All patients had comparable abduction, forward flexion and internal rotation to their uninjured shoulder. We did not observe any relationship between patient demographics, position of implant or etiology and the pattern of osteolysis.

Osteolysis of the distal clavicle and/or coracoid is always seen following synthetic reconstruction of the ACJ using this implant, but is non-progressive. Range of shoulder movement is largely unaffected and patient outcomes remain high.

In older patients (>75 years of age), with an intact rotator cuff, requiring a total shoulder replacement (TSR) there is, at present, uncertainty whether an anatomic TSR (aTSR) or a reverse TSR (rTSR) is best for the patient. This comparison study of same age patients aims to assess clinical and radiological outcomes of older patients (≥75 years) who received either an aTSR or a rTSA. Consecutive patients with a minimum age of 75 years who received an aTSR (n=44) or rTSR (n=51) were prospectively studied. Pre- and postoperative clinical evaluations included the ASES score, Constant score, SPADI score, DASH score, range of motion (ROM) and pain and patient satisfaction for a follow-up of 2 years. Radiological assessment identified glenoid and humeral component osteolysis, including notching with a rTSR. Postoperative improvement for ROM and all clinical assessment scores for both groups was found. There were significantly better patient reported outcome scores (PROMs) in the aTSR group compared with the rTSR patients (p<0.001). Both groups had only minor osteolysis on radiographs. No revisions were required in either group. The main complications were scapular stress fractures for the rTSR patients and acromioclavicular joint pain for both groups. This study of older patients (>75 years) demonstrated that an aTSR for a judiciously selected patient with good rotator cuff muscles can lead to a better clinical outcome and less early complications than a rTSR

Many surgical procedures have been put forth for the management of AC disruption none of them proved to be preferred surgical procedure. To provide better surgical stabilization and functional outcome for the management of AC joint disruption. Study period from 2015 to 2017, total of 14 patients presented with AC joint disruption, patients underwent ethibond fixation and reinforcement with K wire. Out of 14 patients 10 patients participated in the study. The procedure was stabilization of the AC joint by passing the ethibond suture material around the coracoid process and passing through two drill holes made in the clavicle at the attachment of the coracoclavicular ligament. The stabilization was reinforced by passing K wire through the acromion into the lateral end clavicle. After 3 weeks of surgery, K wire was removed and patient was mobilized. Results were assessed by Constant – Murley score. Patients were followed up for 1 year, the mean Constant – Murley score was 86. One patient had infection at the site of k wire entry, another patient had decreased range of movements at the shoulder. No implant back out, no incidence of dislocation were observed. This method proves to be better alternative fixation as compared to only K wire fixation and also it avoids the blow out of clavicle while drilling to pass semitendon as clavicle in Indian population is relatively thinner. This procedure offers better stabilization, less morbidity and improved functional outcome as compared to the other various surgical procedures

The purpose of this study was to determine the motion pattern of the Acromio-Clavicular (AC) joint in a normal shoulder with the use of the new 4 Dimensional CT scan. From April 2010 till January 2011 fourteen healthy volunteers (4 female, 10 male)(mean age 42±11 years) with no previous history of shoulder complaints participated in this study. The 4D CT machine scans motion, allowing a 3D reconstruction of the shoulder joint and its movements. Patients were positioned supine with their arm elevated 90° in the sagittal plane. During the 7 seconds duration of the scan they adducted their arm at that level and then elevated their arm upwards resisted by the gantry for 4 seconds, in this way simulating the clinical Bell-van Riet test for AC pathology. In the transverse plane the mean AC joint space measured in the neutral position is 1.8±0.5 mm. While adducting the arm the AC joint narrows 0.0±0.4 mm (with a positive value being narrowing and a negative value widening). On resisted elevation the joint space is narrowed 0.2±0.6 mm. The mean antero-posterior (AP) translation in this same plane is 0.2±2.2 mm on adduction (with a positive value being posterior translation of the clavicle and a negative value anterior translation) and 0.4±2.9 mm on resisted elevation. The new 4D CT scan demonstrates that the AC joint in a normal shoulder mainly translates in an AP direction, rather than being narrowed or widened, when the arm is adducted (with or without resisted active elevation)

Background. Nonsurgical treatment of Acromioclavicular joint dislocations is well established. Most patients treated conservatively do well, however, some of them develop persistent symptoms. We have used two different surgical reconstruction techniques for Chronic ACJ dislocation stabilization. The study evaluates the effectiveness of a braided polyester prosthetic ligament and modified Weaver-Dunn reconstruction methods. Methods. 55 patients (mean age 42) with Chronic Acromioclavicular joint dislocation were included in this study. They were treated either by a modified Weaver-Dunn method or a braided polyester prosthetic ligament. Patients were assessed using Oxford shoulder score preoperatively and a minimum of 12 months postoperatively. Results. 31 patients (mean age 40, M=24, F=7) were treated by Modified WD method and 24 patients (mean age 44, M=18, F=6) by Surgilig at a mean21 and 24 months post injury. The mode of injury, presentation of symptoms, grade of injury and mean time at surgery post injury was similar in both the groups. There was a significant improvement (p<0.05) in mean pre and postoperative Oxford Shoulder score in both the groups (WD Mean preop OSS=28, postop OSS= 42, Surgilig Mean preop OSS=26, postop OSS=45). The Surgilig group returned to work significantly earlier (Surgilig; mean 6 wks, WD mean 14 wks). There were 3 failures in the WD group and 1 in Surgilig. Superficial infection was seen in 3 patients requiring antibiotics only. Most of the patients from both groups were satisfied with their result except for 3 patients, one which developed complex regional pain syndrome and two developed secondary shoulder problems resulting in ongoing pain. Conclusions. Chronic ACJ dislocations can be successfully treated surgically by either Weaver-Dunn or Surgilig based on similar satisfaction scores amongst patients of both groups. In this study Surgilig had higher overall success rate, less incidence of failure and allowed earlier return to work

Crosby and Colleagues described 24 scapula fractures in 400 reverse shoulder arthroplasties and classified scapula fractures after reverse shoulder arthroplasty into 3 types. Type 1 – true avulsion fracture of acromion related to a thinned out acromion (post-acromioplaty or cuff arthropathy). A small bone fragment dislodges during reduction of RSA. Type 2 – Acromial fracture due to Acromio-clavicular (AC) joint arthrosis. They feel the lack of movement at the AC joint leads to stresses across the acromion and cause it to fracture. They recommend AC joint resection and ORIF of acromion, if the acromion is unstable. Type 3 – true scapula spine fracture caused by the superior screw acting as a stress riser. This fracture occurs about 8 months after the arthroplasty and is a true stress fracture requiring open reduction and internal fixation. Of 123 reverse shoulder arthroplasties performed from Jan 2003 to Feb 2011, a total of 6 scapula fractures were encountered post-surgery. Three were acromial fractures and three were scapula spine fractures all related to trauma. The fractures of the spine occurred between 6 months and 4 years post arthroplasty. We feel the fractures were traumatic but did occur through the posterior or superior screws from the metaglen. where stress risers developed for a fracture to occur. We found that using a sliding osteotomy of the spine of the scapula to bridge the defect of the scapula and a double-plating technique using two plates at 90 degrees to each other provides a satisfactory outcome after 3–6 months where patients can start actively elevating again. This method of treatment will be presented

After shoulder arthroplasty many pain generators may continue to play a role and these might otherwise be missed in a patient where the post-operative radiograph looks fine. Such conditions might include pain from an adjacent location such as the AC joint, or stress fracture of the acromion with reverse prostheses. Unrecognised infection or rotator cuff tear are also factors to consider. Moreover, anxiety and depression may be relevant to the outcome of shoulder arthroplasty

The importance of mitigating pain for patients undergoing total shoulder arthroplasty is extremely relevant for purposes of being able to initiate early functional rehabilitation and activities of daily living. The process, however, does not commence after surgery but rather before surgery. Careful patient education and instruction, including pre-operative exercises to maximise mobility, strength and endurance within the limited range of motion is quite helpful. Adjunctive therapy includes preemptive ultrasound-guided intrascalene regional anesthesia, immediate post-operative peri-incisional injection of liposomal bupivacaine, post-operative use of waterproof Tegaderm. TM. dressing to allow warm showers early on in the rehabilitation period, peri-operative use of Cox 2 inhibitors and a gentle, therapist-guided passive exercise program focusing on relaxation techniques. This in combination with patient-controlled analgesic pumps, careful surgical technique providing adequate soft tissue releases and removal of potential pain generators such as the long tendon of the biceps and an arthritic AC joint all contribute to the minimization of the patient's pain experience, and offers relatively early weaning from parenteral narcotics in the first 24 hours, and oral narcotics within the first 7–10 days post-operatively

The incidence of frozen shoulder (FS) as a complication of simple arthroscopic shoulder surgery has yet to be defined. A single-surgeon case series of patients undergoing arthroscopic subacromial decompression (ASD) or ASD with arthroscopic acromioclavicular joint (ACJ) excision was analysed to establish FS rate, this cohort was then compared to a matched group of primary FS patients. Retrospective analysis of 200 consecutive cases was undertaken. All procedures listed, performed and reviewed by the senior author. 96 underwent ASD and 104 underwent ASD and ACJ excision. 6-months follow-up minimum. Incidence of frozen shoulder was 5.21% (ASD) and 5.71% (ASD+ACJ excision). Mean age was 52.3 years (95% CI: 47.4 to 57.2) of the patients that developed FS, compared to 57.2 years (95% CI: 55.2 to 59.2) in the patients who did not and 52 years (95% CI: 50.7 to 53.3) in the primary FS cohort (n=136). 9.1% of post-operative FS were diabetic compared to 17.1% of primary FS. 63.6% were female in the post-operative FS group, 47.1% in the primary FS group. Our results suggest that the risk of FS following simple arthroscopic procedures is 5%, with no increased risk if the ACJ is also excised. This cohort has the same average age as a primary FS. There is a trend toward female sex and diabetes does not increase the risk

Introduction. Resurfacing of the glenohumeral joint has gained popularity since its first introduction in 1958. Advantages of resurfacing over conventional shoulder arthroplasty include preservation of humeral bone stock, closer replication of individual anatomy, reduction of periprosthetic fracture risk, non-violation of medullary canal, and ease of revision to a stemmed component if needed. Materials and Methods. We reviewed a group of patients with arthrosis of the glenohumeral joint who underwent humeral resurfacing, and who were at a minimum of two years post surgery. From January 2000 to March 2011, 51 humeral resurfacing procedures were performed in 49 patients. Patients were contacted for review, and assessed using patient reported outcome measures. An Oxford Shoulder score as well as a subjective satisfaction and outcome questionnaire was completed, as well as details regarding further surgery or revision. 2 patients had died, 11 patients were not contactable, and in 4 the medical files had been lost. In the remaining 32 shoulders, the average follow-up was 5.9 years. The mean age at time of surgery was 62.3 years (range 36 to 84). Results. Complications included 7 revisions (average 2.4 years post surgery), a further 2 patients await revision. There were 2 subscapularis tendon ruptures managed operatively. A further 2 patients required surgery – one for impingement and acromioclavicular joint arthrosis, and the other for instability. The mean Oxford Shoulder score in the unrevised shoulders was 35.4 (range 10 to 47). Conclusion. We have encountered a high rate of revision in patients undergoing humeral resurfacing for glenohumeral arthrosis. In those who have not been revised, there is a wide spread of patient satisfaction as evidenced by the subjective outcome scores. NO DISCLOSURES