Table 3.

Key Points

An extensive preoperative evaluation is necessary to determine that the meso-acromion is the source of the patient's symptoms.

The surgeon should perform precise portal placement in the subacromial space with the lateral portal placed 2.5 cm off the lateral edge of the acromion in line with the posterior aspect of the acromioclavicular joint.

The surgeon should perform subperiosteal dissection of all soft tissues of the undersurface of the acromion with a radiofrequency device outlining the lateral, medial, and anterior aspects of the meso-acromion.

Hypotensive anesthesia should be used to ensure adequate visualization.

The surgeon should perform meticulous use of a burr to excise the meso-acromion but not disrupt the deltoid periosteal sleeve to the remainder of the acromion.