Arthroscopic Stabilisation for shoulder instability
Latarjet for Instability
Care By Professionals You Can Trust
Adding life to years not years to life
Reverse Shoulder Replacement
Acromioclavicular (AC) Joint Injury
Acromioclavicular joint (ACJ) injuries are very common sporting injuries. Acute traumatic injuries occur with contact and collision sports, horse riding and motorsports. Repetitive traumatic injuries occur with overhead sports, boxing and weightlifting. Many ACJ injuries can be managed with rest and activity modification, however sometimes surgery is indicated. There is a traditional consensus that dictates surgery is indicated for higher-grade (IV–VI) ACJ injuries and lower grade injuries can be managed non-operatively, however treatment based purely on classifications have been shown to be unreliable. Therefore, a more symptom-based management approach is more pragmatic. Traditional surgical fixation techniques have also had high failure rates, but recent anatomically-based reconstructions with stronger materials and biomechanics seem to provide more reliable outcomes in athletes.
The development of strong anatomical reconstructions and a more patient-specific approach to management, based on careful patient and procedure selection, has improved the management and outcomes for athletes. In this chapter, we aim to summarize the anatomy and biomechanics of the AC joint as well as the assessment, diagnosis, and treatment protocols, including our preferred protocol, for the range of ACJ injuries.