Current Concepts in the Treatment of Acromioclavicular Joint Dislocations

Managing and recognizing complications after treatment of acromioclavicular joint repair or reconstruction

“…Studies in the literature that directly compare anatomic and nonanatomic techniques show improved results with the anatomic technique [26,47]. Because of the reconstruction technique, repair can be performed in a subacute fashion.…”

Classifications in Brief: Rockwood Classification of Acromioclavicular Joint Separations

“…When Rockwood expanded the three-part classifications of Allman [1] and Tossy et al [32], it was accepted among surgeons that Types I and II were treated nonoperatively, that Types IV, V, and VI might best be treated by surgery, and that management of Type III injuries was controversial. This consensus holds today [4,5,13,18,21,28,31], and the controversy regarding treatment of Type III persists. Historically, studies have shown good clinical results with nonoperative treatment of Type III injuries [4,7,17,23,30], whereas others have shown greater success with surgical treatment [11,14].…”

“…Various surgical techniques, anatomic and nonanatomic, and recommendations regarding timing of surgical intervention have been described, but no consensus on optimal treatment exists [5,13]. Treatment for Type III injuries also must be individualized based on factors like the patient's activity level, functional impairment, occupational demands, type of sport, level of play, and the patient's aesthetic preferences regarding the injured shoulder.…”

Acromioclavicular Joint Reconstruction

“…The Weaver-Dunn technique involves transfer of the coracoacromial ligament to the distal clavicle. 4 However, this ligament is not as strong as the native CC ligaments and does not reconstruct the acromioclavicular ligaments (Table 2). 11,12 Anatomic CC ligament reconstruction may be performed in both acute and chronic cases.…”

“…3 Although no gold standard currently exists for ACJ reconstruction, numerous surgical treatment options exist for achieving adequate fixation, including the Bosworth screw, Kirschner wires, or a hook plate. 4,5 All of these methods have more optimal results when performed acutely, but they are associated with hardware breakage, migration, and need for removal. [5][6][7][8] Arthroscopic cortical fixation techniques are less invasive but do not anatomically reconstruct the acromioclavicular ligaments.…”