Assessment of clavicular translation after arthroscopic Mumford procedure: Direct versus indirect resection-A cadaveric study

Purpose: To compare the horizontal stability of the distal clavicle following arthroscopic resection of its lateral end by direct and indirect techniques.Type of study: Biomechanical test of cadaveric specimens.Methods: We performed arthroscopic distal clavicle resection on 12 fresh-frozen human cadaveric shoulders using direct (group 1, n = 6) or indirect (group 2, n = 6) approaches. In both groups 5 mm of distal clavicle were resected using an arthroscopic burr. The specimens were mounted on a materials testing device that allowed translation of the clavicle along the anteroposterior axis. The degree of posterior translation was measured from maximum anterior displacement of the clavicle.Results: Mean posterior translation was 19.4 mm (range, 18 to 23 mm; SD, 2.2) and 21.3 mm (range, 18 to 25 mm; SD, 3.1) for groups 1 and 2, respectively. This difference was not statistically significant (P = .27).Conclusions: This study suggests that there is no significant difference in anteroposterior stability of the clavicle following arthroscopic distal clavicle resection with either a direct or indirect approach.Clinical relevance: Clinically, this study addresses concerns about increased potential instability associated with the indirect technique of distal clavicle resection. From a biomechanical standpoint, based on this study, there is no concern for increased instability with the indirect technique of distal clavicle resection compared to a direct technique.