83 patients (83 shoulders) with asymptomatic acromioclavicular arthritis were randomized to examine whether rotator cuff repair combined with acromioclavicular joint resection improved shoulder function. Patients received either rotator cuff repair combined with distal clavicle resection or isolated rotator cuff repair and were assessed after 2 years. Results indicated that distal clavicle resection with rotator cuff repair led to lower functional scores in the early postoperative periods; however, this combined procedure resulted in better functional outcome and pain relief after 2 years when compared to isolated rotator cuff repair.