{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T22:15:45Z","timestamp":1790201745871,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2006,5,1]],"date-time":"2006-05-01T00:00:00Z","timestamp":1146441600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2006,5,1]],"date-time":"2006-05-01T00:00:00Z","timestamp":1146441600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2006,5]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To test the hypothesis that the direct (superior) approach to arthroscopic distal clavicle resection is as safe and effective as the bursal (subacromial) approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All patients who had an arthroscopic distal clavicle resection in our institution between 1994 and 2002 were reviewed. Patients with a history of acromioclavicular joint (ACJ) instability, previous shoulder surgery, glenohumeral pathology, full\u2010thickness rotator cuff tear, or other significant orthopaedic comorbidity were excluded. Outcome data were collected including the American Shoulder and Elbow Surgeons (ASES) score as well as subjective ratings of pain and instability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Follow\u2010up was completed on 66 shoulders of 60 patients. Twenty\u2010four shoulders had a bursal approach (group I) and 42 had a direct approach (group II). There were 45 men and 15 women with an average age of 46 years (range, 21 to 78 years). Follow\u2010up averaged 6.0 years (range, 2 to 11.5 years). The average ASES score was 90 (range, 53\u2010100) in group I and 94 (range, 55\u2010100) in group II. Four patients (10%) in group II required reoperation: 2 patients required ACJ stabilization at 6 and 9 months postoperatively because of anteroposterior instability, and 2 patients required resection again at 5 years because of recurrent symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Both the direct and bursal approaches lead to satisfactory outcomes in the majority of patients with ACJ arthrosis. However, the direct approach to the ACJ may damage the superior capsular ligaments, potentially leading to distal clavicle instability. Care should be taken when performing the direct ACJ resection to avoid disrupting the capsular restraints.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level IV therapeutic case series.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2006.01.013","type":"journal-article","created":{"date-parts":[[2006,5,2]],"date-time":"2006-05-02T18:43:55Z","timestamp":1146595435000},"page":"516-520","source":"Crossref","is-referenced-by-count":45,"title":["Arthroscopic Distal Clavicle Resection: A Comparison of Bursal and Direct Approaches"],"prefix":"10.1002","volume":"22","author":[{"given":"William N.","family":"Levine","sequence":"first","affiliation":[{"name":"Center for Shoulder, Elbow and Sports Medicine Columbia University Columbia University Medical Center New York New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximillian","family":"Soong","sequence":"additional","affiliation":[{"name":"Center for Shoulder, Elbow and Sports Medicine Columbia University Columbia University Medical Center New York New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher S.","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Center for Shoulder, Elbow and Sports Medicine Columbia University Columbia University Medical Center New York New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodore A.","family":"Blaine","sequence":"additional","affiliation":[{"name":"Center for Shoulder, Elbow and Sports Medicine Columbia University Columbia University Medical Center New York New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis U.","family":"Bigliani","sequence":"additional","affiliation":[{"name":"Center for Shoulder, Elbow and Sports Medicine Columbia University Columbia University Medical Center New York New York U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2006,5,1]]},"reference":[{"key":"e_1_2_2_2_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.59B2.873977"},{"key":"e_1_2_2_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198303000-00010"},{"key":"e_1_2_2_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198203000-00015"},{"key":"e_1_2_2_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198304000-00020"},{"key":"e_1_2_2_6_1","volume-title":"Degenerative changes of the sternoclavicular and acromioclavicular joints in various decades","author":"DePalma A.","year":"1957"},{"key":"e_1_2_2_7_1","doi-asserted-by":"publisher","DOI":"10.1053\/jars.2001.25247"},{"key":"e_1_2_2_8_1","first-page":"35","article-title":"Arthroscopic distal clavicle resection","volume":"47","author":"Bell R.H.","year":"1998","journal-title":"Instr Course Lect"},{"key":"e_1_2_2_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0030-5898(21)00042-0"},{"key":"e_1_2_2_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0749-8063(92)90131-T"},{"key":"e_1_2_2_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/0749-8063(92)90136-Y"},{"key":"e_1_2_2_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1058-2746(10)80007-2"},{"key":"e_1_2_2_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/036354659302100113"},{"key":"e_1_2_2_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01560209"},{"key":"e_1_2_2_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199404000-00028"},{"key":"e_1_2_2_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-8063(98)70120-3"},{"key":"e_1_2_2_17_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200103000-00003"},{"key":"e_1_2_2_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/0749-8063(95)90061-6"},{"key":"e_1_2_2_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0030-5898(21)00043-2"},{"key":"e_1_2_2_20_1","doi-asserted-by":"publisher","DOI":"10.1053\/jars.2000.5875"},{"key":"e_1_2_2_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/036354659101900102"},{"key":"e_1_2_2_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199803000-00019"},{"key":"e_1_2_2_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0736-0266(02)00197-3"},{"key":"e_1_2_2_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0749-8063(99)70028-9"},{"key":"e_1_2_2_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1058-2746(99)90003-4"},{"key":"e_1_2_2_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0278-5919(03)00014-0"}],"container-title":["Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0749806306001058?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0749806306001058?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.arthro.2006.01.013","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1016\/j.arthro.2006.01.013","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.arthro.2006.01.013","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T08:48:42Z","timestamp":1773564522000},"score":1,"resource":{"primary":{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/10.1016\/j.arthro.2006.01.013"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,5]]},"references-count":25,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2006,5]]}},"alternative-id":["10.1016\/j.arthro.2006.01.013"],"URL":"https:\/\/doi.org\/10.1016\/j.arthro.2006.01.013","archive":["Portico"],"relation":{},"ISSN":["0749-8063","1526-3231"],"issn-type":[{"value":"0749-8063","type":"print"},{"value":"1526-3231","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,5]]}}}