Abstract
The acromioclavicular joint represents the link between the clavicle and the scapula, which is responsible for the synchronized dynamic of the shoulder girdle. Chronic acromioclavicular joint instability involves changes in the orientation of the scapula, which provokes cinematic alterations that might result in chronic pain. Several surgical strategies for the management of patients with chronic and symptomatic acromioclavicular joint instability have been described. The range of possibilities includes anatomical and non-anatomical techniques, open and arthroscopy-assisted procedures, and biological and synthetic grafts. Surgical management of chronic acromioclavicular joint instability should involve the reconstruction of the torn ligaments because it is accepted that from three weeks after the injury, these structures may lack healing potential. Here, we provide a review of the literature regarding the management of chronic acromioclavicular joint instability.Level of evidenceExpert opinion, Level V.
Highlights
The acromioclavicular joint represents the link between the clavicle and the scapula, which is responsible for the synchronized dynamic of the shoulder girdle
Chronic acromioclavicular joint instability involves changes in the orientation of the scapula, which provokes cinematic alterations that might result in chronic pain
The acromioclavicular joint (ACJ) represents the link between the clavicle and the scapula, which is responsible for the synchronized dynamic of the shoulder girdle [1]
Summary
The acromioclavicular joint represents the link between the clavicle and the scapula, which is responsible for the synchronized dynamic of the shoulder girdle. Surgical management of chronic acromioclavicular joint instability should involve the reconstruction of the torn ligaments because it is accepted that from three weeks after the injury, these structures may lack healing potential. It has been shown that most patients with a history of unstable ACJ injuries managed conservatively develop changes in the anatomical orientation of the scapula, which provokes alterations in the dynamics of the rotator cuff, which can eventually predispose chronic pain [2]. As the AC and CC ligaments lose their potential to heal from 3 weeks after the ACJ injury [6], the management of chronic ACJ instability must involve biological augmentation as well as mechanical fixation [7]. J Orthop Traumatol (2017) 18:305–318 and lack primary mechanical fixation [9] that protects the graft during integration to the bone
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