The acromioclavicular joint is involved in four out of ten shoulder injuries. The joint is prone to injury due to its anatomy and relative lack of soft tissue cover. Sportsmen involved in contact sports are likely to suffer damage to the joint during their professional careers. Most subluxations of the joint can be treated nonoperatively whilst dislocations are generally treated operatively except in those individuals at significant risk of re-injury, for example, rugby players. This article looks at the anatomy and physiology of the acromioclavicular joint, injury classification and presents the current evidence regarding treatment options for these injuries.
Allman FL.1967. Fractures and ligamentous injuries of the clavicle and its articulation. J Bone Joint Surg Am49: 774-784.
2.
Berkowitz M, Warren R.1997. Arthroscopic acromioclavicular resection. Op Techniques Sports Med5: 100-104.
3.
Bradley JP, Elkousy H.2003. Decision making: operative versus nonoperative treatment of acromioclavicular joint injuries. Clin Sports Med22(2): 277-290.
4.
Breslow MJ, Jazrawi LM, Bernstein AD.2002. Treatment of acromioclavicular joint separation: suture or suture anchors?J Shoulder Elbow Surg11(3): 225-229.
5.
Cave EF ed. 1961. Fractures and other injuries. Chicago: Year Book Medical Publishers.
6.
Fukuda K, Craig E, An KNet al.1986. Biomechanical study of the ligamentous system of the acromioclavicular joint. J Bone Joint Surg (Am)68: 434-440.
7.
Galpin RD, Hawkins RJ, Grainger RW.1985. A comparative analysis of operative versus non-operative treatment of Grade III acromioclavicular separations. Clin Orthop193: 150-155.
8.
Henry M, Liu S, Loffredo AJ.1995. Arthroscopic management of the acromioclavicular joint disorder. Clin Orthop316: 276-283.
9.
Kocher M, Duipre M, Feagin JA Jr.1998. Shoulder injuries from alpine skiing and snowboarding: aetiology, treatment and prevention. Sports Med25: 201-211.
10.
Larsen E, Bjerg-Neilsen A, Christensen P.1986. Conservative or surgical treatment of acromioclavicular dislocation. Aprospective, controlled, randomized study. J Bone Joint Surg (Am)68(4): 552-555
11.
Lee K, Debski R, Chen CHet al.1997. Functional evaluation of the ligaments of the acromioclavicular joint during anteroposterior and superoinferior translation. Am J Sports Med25: 858-862.
12.
Lemos MJ, Tolo ET.2003. Complications of the treatment of the acromioclavicular and sternoclavicular joint injuries, including instability. Clin Sports Med22(2): 371-385.
13.
Madsen B.1963. Osteolysis of the acromion end of the clavicle following trauma. Br J Radiol36: 822-828.
Motamedi AR, Blevins FT, Willis MCet al.2000. Biomechanics of the coracoclavicular ligament complex and augmentations used in its repair and reconstruction. Am J Sports Med28(3): 380-384.
16.
Mouhsine E, Garofalo R, Crevoisier X, Farron A.2003. Grade I and II acromioclavicular dislocations: results of conservative treatment. J Shoulder Elbow Surg12(6): 599-602
17.
Norfray J, Tremaine M, Groves HC.1997. The clavicle in hockey. Am J Sports Med5: 275-280.
18.
Orchard J.2001. The use of local anaesthetic injections in professional football. Br J Sports Med35(4): 212-213.
Reichkendler M, Rangger C, Dessl A, Ulmer H.1996. Comparison and outcome of grade II and III acromioclavicular joint injuries [in German]. Unfallchirurg99: 778-783.
21.
Rockwood CA, Green DP, eds. 1996. Fractures in adults. Philadelphia: Lippincott-Raven, 1341-1413.
22.
Rudzki JR, Matava MJ, Paletta GA Jr.2003. Complications of treatment of acromioclavicular and sternoclavicular joint injuries. Clin Sports Med22(2): 387-405.
23.
Tossy JD, Mead NC, Sigmond HM.1963. Acromioclavicular separation: useful and practical classification for treatment. Clin Orthop28: 111-119.
24.
Weaver J, Dunn H.1972. Treatment of acromioclavicular injuries, especially complete acromioclavicular separation. J Bone Joint Surg54A: 1187-1194.
25.
Yap JJ, Curl LA, Kvitne RSet al.1999. The value of weighted views of the acromioclavicular joint: results of a survey. Am J Sports Med27: 806-809.
26.
Zanca P.1971. Shoulder pain; involvement of the AC joint: analysis of 1,000 cases. AJR Am J Roentgenol112: 493-506.
