Shoulder pathology associated with symptomatic acromioclavicular joint degeneration

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Shoulder Pathology

Background:

• Symptomatic degenerative change in the acromioclavicular (AC) joint is a common cause of shoulder pain.
• The relationship between AC joint pathology and other shoulder structures, such as the rotator cuff and labrum, requires further elucidation.

Purpose of the Study:

• To determine the incidence and nature of coexisting shoulder pathologies in patients with symptomatic AC joint degeneration.
• To analyze age-related differences in the prevalence of these associated shoulder conditions.

Main Methods:

• Retrospective review of 218 shoulders undergoing surgery for symptomatic AC joint degeneration.
• Detailed assessment of intraoperative findings, including rotator cuff, labral, glenohumeral, and biceps tendon pathology.
• Stratification of findings based on patient age (<50 years vs. ≥50 years).

Main Results:

• A high prevalence (97.7%) of coexisting shoulder pathologies was observed in 213 of 218 shoulders.
• Rotator cuff degeneration (79 shoulders with full-thickness tears) and labral tears (72 shoulders) were the most common findings.
• In patients <50 years, labral tears (42%) and rotator cuff disease (65%, often incomplete tears) were more prevalent.
• In patients ≥50 years, intact rotator cuffs were rare (14%), with 72 full-thickness tears and 29% labral tears.

Conclusions:

• Degenerative acromioclavicular joint disease frequently coexists with significant rotator cuff and labral pathology.
• Age influences the type and prevalence of associated shoulder conditions, with younger patients showing more labral tears and older patients more advanced rotator cuff tears.
• Arthroscopic evaluation of the entire shoulder is recommended at the time of acromioclavicular joint surgery to address all pathologies.