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Acromioclavicular joint injuries: diagnosis and management
Ryan Simovitch1, Brett Sanders, Mehmet Ozbaydar
1Palm Beach Orthopaedic Institute, Palm Beach Gardens, FL 33410, USA.
The Journal of the American Academy of Orthopaedic Surgeons
|March 25, 2009
Summary
Acromioclavicular joint injuries are common in athletes. Treatment varies by injury type, with surgical reconstruction being most effective for persistent instability.
Area of Science:
- Orthopedics
- Sports Medicine
- Anatomy
Background:
- Acromioclavicular (AC) joint injuries account for nearly half of all athletic shoulder injuries.
- Injury mechanism often involves a fall onto the shoulder with the arm adducted.
- Joint stability relies on AC ligaments, capsule, coracoclavicular ligaments, and surrounding muscles (trapezius, deltoid).
Purpose of the Study:
- To review the evaluation and management of acromioclavicular joint injuries.
- To discuss treatment strategies based on injury classification.
- To highlight effective surgical techniques for persistent instability.
Main Methods:
- Clinical examination for tenderness and instability.
- Radiographic assessment for diagnosis.
- Review of current treatment guidelines and surgical techniques.
Main Results:
- Nonsurgical treatment is standard for Type I and II AC joint injuries.
- Surgery is typically recommended for Type IV, V, and VI injuries.
- Type III injuries present a management dilemma, often treated non-surgically unless instability is symptomatic.
Conclusions:
- Acromioclavicular joint injury management is guided by injury type and severity.
- Surgical reconstruction techniques, including coracoclavicular ligament reconstruction, are effective for persistent instability.
- Anatomic AC joint reconstruction demonstrates superior biomechanical outcomes for chronic instability.
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