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Management of acute unstable acromioclavicular joint injuries

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Abstract

Surgical management of acute unstable acromioclavicular joint injuries should be focused on realigning the torn ends of the ligaments to allow for healing potential. The most widely utilized treatment methods incorporate the use of metal hardware, which can alter the biomechanics of the acromioclavicular joint. This leads to a second surgical procedure for hardware removal once the ligaments have healed. Patients with unstable acromioclavicular joint injuries managed with arthroscopy-assisted procedures have shown good and excellent clinical outcomes, without the need for a second operation. These procedures incorporate a coracoclavicular suspension device aimed to function as an internal brace, narrowing the coracoclavicular space thus allowing for healing of the torn coracoclavicular ligaments. The lesser morbidity of a minimally invasive approach and the possibility to diagnose and treat concomitant intraarticular injuries; no obligatory implant removal, and the possibility of having a straight visualization of the inferior aspect of the base of the coracoid (convenient when placing coracoclavicular fixation systems) are the main advantages of the arthroscopic approach over classic open procedures. This article consists on a narrative review of the literature in regard to the management of acute acromioclavicular joint instability.

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Acknowledgments

Authors would like to thank our colleague and friend, Pau Golano, for his contribution with the pictures of the cadaveric specimens of Fig. 2.

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  1. Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Street Sant Quintí 89, 08026, Barcelona, Catalunya, Spain

    Luis Natera Cisneros & Juan Sarasquete Reiriz

  2. Hospital General de Catalunya, Street Pedro i Pons 1, 08190, Sant Cugat del Vallés, Catalunya, Spain

    Luis Natera Cisneros

  3. Hospital Quirón Teknon, Street Vilana 12, 08022, Barcelona, Catalunya, Spain

    Juan Sarasquete Reiriz

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  1. Luis Natera Cisneros
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Correspondence to Luis Natera Cisneros.

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Dr. Luis Natera declares that has no conflict of interest. Dr. Juan Sarasquete receives royalties from Biomet® Sports Medicine.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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For the purposes of this study, there was no need for informed consent from any individual participants included in the study.

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Cisneros, L.N., Reiriz, J.S. Management of acute unstable acromioclavicular joint injuries. Eur J Orthop Surg Traumatol 26, 817–830 (2016). https://doi.org/10.1007/s00590-016-1836-1

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