Arthroscopic Distal Clavicle and Medial Border of Acromion Resection for Symptomatic Acromioclavicular Joint Osteoarthritis  Adinun Apivatgaroon, M.D.,

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Arthroscopic Distal Clavicle and Medial Border of Acromion Resection for Symptomatic Acromioclavicular Joint Osteoarthritis  Adinun Apivatgaroon, M.D., Prakasit Sanguanjit, M.D.  Arthroscopy Techniques  Volume 6, Issue 1, Pages e25-e29 (February 2017) DOI: 10.1016/j.eats.2016.08.033 Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 1 Patient positioning and arthroscopic portals in a right shoulder. The patient is placed in a 70° upright beach-chair position. (ASP, anterosuperior portal; C, coracoid process; LP, lateral portal; PP, posterior viewing portal.) Arthroscopy Techniques 2017 6, e25-e29DOI: (10.1016/j.eats.2016.08.033) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 2 Arthroscopic view from the posterior portal of the right shoulder using a 30° arthroscope. The distal clavicle and the medial border of the acromion are identified. The acromioclavicular joint is identified after removing the surrounding soft tissue and inferior acromioclavicular joint capsule. (A, anterior; P, posterior.) Arthroscopy Techniques 2017 6, e25-e29DOI: (10.1016/j.eats.2016.08.033) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 3 Arthroscopic views from the posterior portal of the right shoulder using a 30° arthroscope. The direction of the anterosuperior working portal should be within 5 mm proximal to the distal edge of the clavicle with a parallel orientation to the acromioclavicular joint. Arthroscopy Techniques 2017 6, e25-e29DOI: (10.1016/j.eats.2016.08.033) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 4 Arthroscopic views from the posterior portal of the right shoulder using a 30° arthroscope. (A) Resection is performed through the anterosuperior working portal. (B, C) Resection starts from the inferior to superior portion of the distal clavicle and the medial border of the acromion. (D) Direction of resection from anterior to posterior. (E) Complete resection of both the distal clavicle and medial acromion. Arthroscopy Techniques 2017 6, e25-e29DOI: (10.1016/j.eats.2016.08.033) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions

Fig 5 Arthroscopic view from the anterosuperior portal of the right shoulder using a 30° arthroscope. Switching the arthroscope to this portal helps to directly examine the resected area, particularly at the posterosuperior border of the acromioclavicular joint (ACJ). (A, anterior; P, posterior.) Arthroscopy Techniques 2017 6, e25-e29DOI: (10.1016/j.eats.2016.08.033) Copyright © 2016 Arthroscopy Association of North America Terms and Conditions