Distal Clavicular Resection Worsens Outcomes in Rotator Cuff Repair: A National Database Study

Joshua M Wiener; Parshva A Sanghvi; Kira A Smith; Andrew Moyal; Molly M Piper; Jacob G Calcei

doi:10.1177/24715492241249374

Distal Clavicular Resection Worsens Outcomes in Rotator Cuff Repair: A National Database Study

J Shoulder Elb Arthroplast. 2024 May 16:8:24715492241249374. doi: 10.1177/24715492241249374. eCollection 2024.

Authors

Joshua M Wiener¹, Parshva A Sanghvi¹, Kira A Smith², Andrew Moyal^{1

2}, Molly M Piper², Jacob G Calcei^{1

2}

Affiliations

¹ Case Western Reserve University School of Medicine, Cleveland, OH, USA.
² University Hospitals Cleveland Department of Orthopedic Surgery, Cleveland, OH, USA.

Abstract

Introduction: Distal clavicular resection (DCR) is a procedure used to alleviate acromioclavicular joint (ACJ) pain, often done alongside rotator cuff repair (RCR). This investigation explored the relationships between DCR and RCR, outcomes of DCR during RCR, and complication rates of DCR.

Methods: This retrospective study used electronic medical record data from the TriNetX database. Cohorts were subdivided based on the timeline of DCR in comparison to RCR, as well as comparing RCR with DCR against RCR without DCR.

Results: In total 46 534 patients underwent RCR with 14.8% (6898) of these patients also undergoing DCR. And 72.8% (5021) had DCR during RCR, and 10.7% (740) had DCR after RCR. Less than 5% (<10) of patients with preexisting ACJ pain required DCR 3 years postoperatively, and 0.002% (78) patients without ACJ pain developed ACJ pain within 3 years. Less that 20 patients underwent DCR within 3 years of being diagnosed with ACJ pain. Patients who had RCR with DCR were more likely to have chronic pain postoperatively (P < .0001).

Conclusion: Patients undergoing RCR do not require subsequent DCR. Performing DCR does not offer significant benefit when compared to performing isolated RCR without DCR in patients with preexisting ACJ pain, but increases risk for ACJ instability and chronic pain.

Keywords: Shoulder; outcomes; rotator cuff tear.