APEX Optimizing Surgical Outcomes for Knee & Shoulder Arthroscopy-Descompresion subacomial y reseccion de clavicula distal

Video Transcription

Video Summary

Michel Ruiz from Mexico City discusses the controversial orthopedic procedures of subacromial decompression and distal clavicle resection. Both have long been used to alleviate pain and improve shoulder function, but recent evidence questions their effectiveness. Meta-analyses and systematic reviews, including a 2018 COR study and a 2024 article, reveal no clear clinical benefits for distal clavicle resection; it may cause residual pain and joint instability, especially if performed extensively. Similarly, Cochrane reviews find subacromial decompression does not reduce pain, improve function, or enhance quality of life—and may increase adverse effects slightly. There is no consensus on indications for these surgeries, though Ruiz continues subacromial decompression conservatively in rare cases with high-grade partial bursal lesions caused by acromial osteophytes. He emphasizes careful surgical technique to preserve ligaments and avoid complications. Ruiz concludes that while frequently performed, these procedures lack proven benefit and calls for universal guidelines to improve decision-making and outcomes.

Asset Caption

Faculty: Michell Ruiz-Suarez, M.D.

Keywords

subacromial decompression

distal clavicle resection

shoulder surgery

orthopedic procedures

clinical effectiveness