Skip to main content

Acromioclavicular Joint Instability: When and How to Operate

  • Chapter
  • First Online:
Management of Failed Shoulder Surgery
  • 771 Accesses

Abstract

In current literature, evidence for treatment of revision ACJ instability is still lacking, but surgical treatment continues to evolve. The importance of failure analysis and clinical relevant algorithms were highlighted in this chapter. It was also intended to point out technical errors and possible solution strategies in order to reduce failure rates and improve clinical outcomes. Precise attention on creating a biomechanically accurate repair is needed, to generate an optimal healing environment that will translate into patient satisfaction and long-term stability.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Williams G, Nguyen V, Rockwood C. Classification and radiographic analysis of acromioclavicular dislocations. Appl Radiol. 1989;18:29–34.

    Google Scholar 

  2. Dias JJ, et al. The conservative treatment of acromioclavicular dislocation. Review after five years. J Bone Joint Surg Br. 1987;69(5):719–22.

    Article  CAS  PubMed  Google Scholar 

  3. Beitzel K, et al. Current concepts in the treatment of acromioclavicular joint dislocations. Arthroscopy. 2013;29(2):387–97.

    Article  PubMed  Google Scholar 

  4. Milewski MD, et al. Complications related to anatomic reconstruction of the coracoclavicular ligaments. Am J Sports Med. 2012;40(7):1628–34.

    Article  PubMed  Google Scholar 

  5. Beitzel K, et al. ISAKOS upper extremity committee consensus statement on the need for diversification of the Rockwood classification for acromioclavicular joint injuries. Arthroscopy. 2014;30(2):271–8.

    Article  PubMed  Google Scholar 

  6. Kibler WB, Sciascia A. Current concepts: scapular dyskinesis. Br J Sports Med. 2010;44(5):300–5.

    Article  PubMed  Google Scholar 

  7. Martetschlager F, et al. Complications after anatomic fixation and reconstruction of the coracoclavicular ligaments. Am J Sports Med. 2013;41(12):2896–903.

    Article  PubMed  Google Scholar 

  8. Tauber M, et al. Arthroscopic stabilization of chronic acromioclavicular joint dislocations: triple-versus single-bundle reconstruction. Am J Sports Med. 2016;44(2):482–9.

    Article  PubMed  Google Scholar 

  9. Mazzocca AD, et al. A biomechanical evaluation of an anatomical coracoclavicular ligament reconstruction. Am J Sports Med. 2006;34(2):236–46.

    Article  PubMed  Google Scholar 

  10. Voss A, et al. A biomechanical analysis of different clavicular tunnel diameters in anatomic acromioclavicular ligament reconstruction. Arthroscopy. 2016;32(8):1551–7.

    Article  PubMed  Google Scholar 

  11. Costic RS, et al. Biomechanical rationale for development of anatomical reconstructions of coracoclavicular ligaments after complete acromioclavicular joint dislocations. Am J Sports Med. 2004;32(8):1929–36.

    Article  PubMed  Google Scholar 

  12. Erak S, et al. Acromioclavicular reconstructions with hamstring tendon grafts: a comparative biomechanical study. J Shoulder Elb Surg. 2008;17(5):772–8.

    Article  Google Scholar 

  13. Beitzel K, et al. Biomechanical comparison of arthroscopic repairs for acromioclavicular joint instability suture button systems without biological augmentation. Am J Sports Med. 2011;39(10):2218–25.

    Article  PubMed  Google Scholar 

  14. Geaney LE, et al. Graft fixation is highest with anatomic tunnel positioning in acromioclavicular reconstruction. Arthroscopy. 2013;29(3):434–9.

    Article  PubMed  Google Scholar 

  15. Klimkiewicz JJ, et al. The acromioclavicular capsule as a restraint to posterior translation of the clavicle: a biomechanical analysis. J Shoulder Elb Surg. 1999;8(2):119–24.

    Article  CAS  Google Scholar 

  16. Beitzel K, et al. Rotational and translational stability of different methods for direct acromioclavicular ligament repair in anatomic acromioclavicular joint reconstruction. Am J Sports Med. 2014;42(9):2141–8.

    Article  PubMed  Google Scholar 

  17. Grantham C, et al. A biomechanical assessment of a novel double endobutton technique versus a coracoid cerclage sling for acromioclavicular and coracoclavicular injuries. Knee Surg Sports Traumatol Arthrosc. 2016;24(6):1918–24.

    Article  PubMed  Google Scholar 

  18. Saier T, et al. Value of additional acromioclavicular cerclage for horizontal stability in complete acromioclavicular separation: a biomechanical study. Knee Surg Sports Traumatol Arthrosc. 2015;23(5):1498–505.

    Article  PubMed  Google Scholar 

  19. Scheibel M, et al. Arthroscopically assisted stabilization of acute high-grade acromioclavicular joint separations. Am J Sports Med. 2011;39(7):1507–16.

    Article  PubMed  Google Scholar 

  20. Woodmass JM, et al. Complications following arthroscopic fixation of acromioclavicular separations: a systematic review of the literature. Open Access J Sports Med. 2015;6:97.

    PubMed  PubMed Central  Google Scholar 

  21. Spiegl UJ, et al. Biomechanical consequences of coracoclavicular reconstruction techniques on clavicle strength. Am J Sports Med. 2014;42(7):1724–30.

    Article  PubMed  Google Scholar 

  22. Martetschläger F, et al. Effect of coracoid drilling for acromioclavicular joint reconstruction techniques on coracoid fracture risk: a biomechanical study. Arthroscopy. 2016;32(6):982–7.

    Article  PubMed  Google Scholar 

  23. Imhoff AB, Braun S, Beitzel K. Comments on complications after arthroscopic coracoclavicular reconstruction using a single adjustable loop length suspensory fixation device. Arthroscopy. 2015;31(6):1031–3.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2018 ESSKA

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Diermeier, T., Dyrna, F., Imhoff, A.B., Beitzel, K. (2018). Acromioclavicular Joint Instability: When and How to Operate. In: Milano, G., Grasso, A., Calvo, A., Brzóska, R. (eds) Management of Failed Shoulder Surgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-56504-9_11

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-56504-9_11

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-56503-2

  • Online ISBN: 978-3-662-56504-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics