The following case is a 49 y/o female who was treated with AC joint cortizone injections for 6 months (2 injections) prior to treatment of her AC joint arthritis with an arthroscopic Mumford procedure. During a previous post (please click
here) it was highlighted that the CA ligament not only provides stability to the cuff deficient and cuff intact shoulder but it also has mechanoreceptors that are important for the proprioception of the shoulder joint.
During the arthroscopic procedure for AC joint arthritis we always preserve the CA ligament by placing our working instruments just medial to the CA ligament as demonstrated below. This technique allows for direct access to the AC joint and resection of 0.5 to 1 cm of distal clavicle which has been proven to prevent AC joint instability and provide adequate relief of symptoms. The posterior superior capsule needs to be preserved as well because it provides stability to the AC joint.
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| Most rotator cuff tears start at the articular side of the supraspinatus tendon and at the leading fibers near biceps |
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| The CA ligament is preserved |
