A Novel and Reproducible Anterior Portal for Arthroscopic Distal Clavicle Excision

Abstract

Acromioclavicular (AC) joint pathology is a common cause of shoulder pain, and arthroscopic distal clavicle resection is a frequently performed procedure for this problem. Here we describe a portal that is directly in line with the AC joint such that the surgeon can easily access the posterosuperior distal clavicle, as this is the region that is most frequently neglected or incompletely resected region with a “standard” or uncontrolled portal. This research provides an anatomic description for creating this anterior portal that preserves local anatomy and is both safe and effective for glenohumeral and AC joint access using reproducible anatomic landmarks. The technique was validated using cadaveric dissection and yields a method of establishing the anterior portal for distal clavicle excision with a safe corridor for placement of instruments in a reliable manner that does not disrupt the important stabilizers of the glenohumeral or AC joints. Level of Evidence: Level IV.