Open Versus Arthroscopic Acromioclavicular Joint Resection: A Retrospective Comparison Study
ABSTRACT The purpose was to compare open and arthroscopic acromioclavicular joint (ACJ) resection.
We retrospectively reviewed 103 patients (105 shoulders) who underwent ACJ resection between 2000 and 2005. There were 56 women and 47 men with a mean age of 48 years. The mean duration of follow-up was 51 months (range, 15 to 91 months). Arthroscopic ACJ resection by use of a direct approach was performed in 81 shoulders (group A), and open ACJ resection was performed in 24 shoulders (group B). Results were graded according to pain relief both subjectively and objectively with cross-body adduction testing and direct palpation of the ACJ, subjective shoulder value, Constant score, and improved function.
The Constant scores increased from 50 (range, 34 to 65) to 89 (range, 39 to 100) in group A (P < .0001) and from 46 (range, 22 to 63) to 87 (range, 43 to 100) in group B (P < .0001). There was no statistical difference in the postoperative normalized Constant score between group A and group B (P = .47). Pain with cross-body adduction testing and palpation of the ACJ improved in 76 shoulders (94%) in group A and 22 shoulders (92%) in group B. No patients had signs or symptoms of ACJ anteroposterior instability. Revision ACJ resection was performed in 5 patients (5 shoulders [6.2%]) in group A and 1 shoulder (4.2%) in group B (P = .37). The radiographs of the patients who underwent revision showed that 3 patients (3.7%) from group A had regrowth of the distal clavicle; in addition, 2 patients (2.5%) from group A and 1 patient (4.3%) from group B had incomplete distal clavicle excision.
This study did not show a significant difference in the outcome between arthroscopic and open ACJ resection. Incomplete excision and regrowth of the distal clavicle are the most common causes of revision. Although only the arthroscopic group showed a small percentage of patients (3.7%) with regrowth of the distal clavicle, the number is too small to assume that this complication is the result of the arthroscopic technique only.
Level IV, therapeutic case series.
Conference Paper: The effect of scaling upto future analog/digital systems[Show abstract] [Hide abstract]
ABSTRACT: As demonstrated over the last decade, the performance of both logic and linear CMOS circuits improve as the technology is scaled. Because of this scaling, increasingty larger integrated analog/digital systems have become possible. Such systems include precision amplification and buffering, as well as microprocessor circuits, logic and memory. This panel will examine the practical issues and future architectural consequences involved in the continued scaling of these systems. The issues include the need for on-chip power regulation, digital versus linear filtering and data conversion and the trend towards digital calibration of linear circuits. In addition, circuit design innovation in analog has been another factor resulting in a moving boundary between analog versus digital performance. On the other hand, the consequences of testing analog rather than digital circuits must also be considered... Panelists will debate the advantages of both digital and linear circuit approaches in future analog/digital systems.Solid-State Circuits Conference. Digest of Technical Papers. 1985 IEEE International; 03/1985
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