Arthroskopie

, Volume 23, Issue 4, pp 273–280 | Cite as

AC-Gelenk-Arthrose

Indikation zur Operation, Techniken der AC-Gelenk-Resektion
Leitthema
First Online:

Zusammenfassung

Das Schultereckgelenk ist maßgeblich an der Kraftübertragung zwischen oberer Extremität und Thorax beteiligt. Aufgrund seiner anatomischen Besonderheiten und extremen mechanischen Beanspruchungen unterliegt es frühzeitigen degenerativen Veränderungen, die zunächst magnetresonanztomographisch, später auch nativradiologisch erfasst werden können. Therapeutisch wegweisend ist daher die klinische Untersuchung, um symptomatische von asymptomatischen Schultereckgelenkarthrosen zu unterscheiden. Differenzialdiagnostisch müssen begleitende Pathologien im Subakromialraum oder Glenohumeralgelenk abgegrenzt werden. Hierzu werden lokale Infiltrationstests angewendet. Scheitern konservative Therapiemaßnahmen, ist das Ziel der operativen Behandlung die Entlastung des Gelenks mit Resektion arthrotischer Anteile und Behebung des schmerzhaften Kontakts der knöchernen Gelenkpartner unter weitestgehender Aufrechterhaltung der ligamentären Stabilität. Hierbei hat sich die arthroskopische Resektion der lateralen Klavikula als ein Standardverfahren etabliert.

Der vorliegende Artikel stellt diagnostische Maßnahmen, operative Techniken und deren Resultate sowie potenzielle Komplikationen vor.

Schlüsselwörter

Akromioklavikular- (AC-)Gelenk Primäre und sekundäre Arthrose Arthroskopische laterale Klavikularesektion 

Arthritis of the acromioclavicular joint

Indications for surgery and techniques for resection

Abstract

The acromioclavicular (AC) joint represents an important link of force transmission between the upper extremities and the thorax. Due to its anatomical and mechanical properties it is prone to early degenerative changes which can be detected initially on magnetic resonance imaging and on conventional radiographs at later stages. For an appropriate therapeutic concept it is essential to differentiate between symptomatic and asymptomatic types of AC joint arthritis using a sophisticated physical examination. As a differential diagnosis, concomitant subacromial or glenohumeral pathologies need to be ruled out and local infiltration tests are useful in this setting. Beyond conservative approaches in the treatment of AC joint arthritis the aim of operative treatment is to avoid painful bony contact by decompressing the joint with resection of the joint surfaces while preserving its ligamentous stability. Arthroscopic resection of the lateral end of the clavicle has become a standard procedure in the treatment of AC joint arthritis.

The present article summarizes diagnostic strategies, surgical techniques and their respective results and complications.

Keywords

Acromioclavicular joint Primary and secondary osteoarthritis Arthroscopic lateral clavicular resection 
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Notes

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  1. 1.Centrum für Muskuloskeletale ChirurgieCharité-Universitätsmedizin Berlin, Campus Virchow-KlinikumBerlinDeutschland

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