Purpose: To develop a consensus on diagnosis and treatment of acromioclavicular joint instability.
Methods: A consensus process following the modified Delphi technique was conducted. Panel members were selected among the European Shoulder Associates of ESSKA. Five rounds were performed between October 2018 and November 2019. The first round consisted of gathering questions which were then divided into blocks referring to imaging, classifications, surgical approach for acute and chronic cases, conservative treatment. Subsequent rounds consisted of condensation by means of an online questionnaire. Consensus was achieved when ≥ 66.7% of the participants agreed on one answer. Descriptive statistic was used to summarize the data.
Results: A consensus was reached on the following topics. Imaging: a true anteroposterior or a bilateral Zanca view are sufficient for diagnosis. 93% of the panel agreed on clinical override testing during body cross test to identify horizontal instability. The Rockwood classification, as modified by the ISAKOS statement, was deemed valid. The separation line between acute and chronic cases was set at 3 weeks. The panel agreed on arthroscopically assisted anatomic reconstruction using a suspensory device (86.2%), with no need of a biological augmentation (82.8%) in acute injuries, whereas biological reconstruction of coracoclavicular and acromioclavicular ligaments with tendon graft was suggested in chronic cases. Conservative approach and postoperative care were found similar CONCLUSION: A consensus was found on the main topics of controversy in the management of acromioclavicular joint dislocation. Each step of the diagnostic treatment algorithm was fully investigated and clarified.
Level Of Evidence: Level V.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8225517 | PMC |
| http://dx.doi.org/10.1007/s00167-020-06286-w | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Subacromial Distal Clavicle Dislocation with Associated Scapular Spine Fracture: A Case Report.
J Orthop Case Rep
January 2025
Vanderbilt University Medical Center, Department of Orthopaedic Surgery, 1215 21st Ave S, Suites 3200 and 4200, Nashville, TN, 37232, 2John Hopkins University.
Introduction: Inferior or subacromial dislocation of the distal clavicle is a rare entity. Previous reports of this injury pattern have largely been limited to Rockwood VI acromioclavicular joint (AC) dislocations, with the distal clavicle located in the subcoracoid position. Few case reports have been described with the inferior clavicle being located in the subacromial space, and these have all been previously associated with clavicle fractures.
View Article and Find Full Text PDFA ten-year prospective randomized trial comparing non-operative treatment to hook plate fixation for Rockwood III acromio-clavicular dislocation.
Orthop Traumatol Surg Res
January 2025
Faculté de médecine Université Laval, Pavillon Ferdinand-Vandry, 1050 avenue de la Médecine, Québec, Québec G1V 0A6, Canada; Département de chirurgie Université Laval, Pavillon Ferdinand-Vandry, 1050 avenue de la Médecine, Québec, Québec G1V 0A6, Canada; Centre de Recherche CHU de Québec Université Laval, Axe Médecine Régénératrice, 2705 Bd Laurier, Québec, Québec G1V 4G2, Canada. Electronic address:
Background: Despite new modern surgical techniques, no short-term functional differences have been demonstrated between operative and non-operative treatment for acute acromio-clavicular (AC) dislocations Rockwood III-V. Few studies describe the long-term clinical and radiological results of these lesions. We aim to compare the one- and ten-year outcome of patients either treated non-operatively or with hook plate fixation for Rockwood III AC lesions.
View Article and Find Full Text PDFDisparities in Operative Fixation for Acromioclavicular Joint Injuries: An Analysis of Insurance Status.
J Shoulder Elbow Surg
January 2025
Department of Orthopaedic Surgery, Hackensack Meridian Health, Hackensack, NJ, USA.
Background: Acromioclavicular (AC) joint injury management has historically been guided by the severity and grade of the injury. However, recent debates have emerged regarding the role of surgical intervention for these injuries. Insurance-based disparities in surgical treatment have been well-documented across various orthopedic conditions.
View Article and Find Full Text PDFSubacromial Pain Syndrome in Breast Cancer Survivors-Are Structural Shoulder Changes Verified by Ultrasound Clinically Relevant?
Diagnostics (Basel)
December 2024
Department of Physiotherapy, University Department of Health Studies, University of Split, 21000 Split, Croatia.
: Shoulder pain is a common treatment outcome in breast cancer survivors. While various risk factors and mechanisms for shoulder pain have been proposed, evidence is inconsistent. Increased risk of subacromial pain syndrome exists, which can lead to disability and reduced quality of life if untreated.
View Article and Find Full Text PDFDistal augmentation in unstable distal clavicle fractures: a retrospective cohort study of 101 cases.
Arch Orthop Trauma Surg
January 2025
The Department of Orthopaedic Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123, Ta Pei Road, Niao Sung Dist, Kaohsiung, Taiwan.
Introduction: The optimal management strategy for unstable distal clavicular fractures remains controversial. Recent studies on plate techniques have reported good-to-excellent outcomes with no serious complications. The questions are that: (1) Does the use of wire augmentation with locking plate in distal part (distal wire augmentation) reduce radiographic loss of reduction (RLOR) and get earlier bony union in distal clavicular fractures? (2) Which fixation methods are associated with a higher incidence of acromioclavicular (AC) joints arthritis or subluxation? We collected and analyzed clinical studies on different plate fixation methods for unstable fractures to identify the best surgical modality.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!