Two hundred patients with an isolated distal or middle rupture of the supraspinatus tendon were randomized to undergo an arthroscopic rotator cuff repair either with the addition of a distal clavicle resection (DCR) (n=97) or arthroscopic rotator cuff repair only (n=103). The primary outcome of interest included the Constant-Murley score. Additional outcomes of interest included the subjective shoulder value (SSV), active range of motion in forward flexion, external rotation (ER) with elbow at side, internal rotation (IR) with hand in the back. As well, residual pain was assessed using the following measures: pain on a Visual Analogue Scale (VAS), and the incidence of pain on superior aspect of shoulder, acromioclavicular (AC) pain upon palpation, cross-arm test elicits pain, and upper trapezius. All outcomes were evaluated up to 1-year post-surgery. Results revealed that external rotation range of motion and SSV both statistically significantly worse in the DCR group when compared to the control (p=0.04 for both). In addition, the DCR group had statistically significantly more residual pain as demonstrated by the increase in the incidence of pain on the superior aspect of the shoulder (p=0.03).