Optimal Management of Acromioclavicular Dislocation: Current Perspectives

Philip C Nolte,1,2 Lucca Lacheta,1,3 Travis J Dekker,1,4 Bryant P Elrick,1 Peter J Millett1,5 1Steadman Philippon Research Institute, Vail, CO, USA; 2Department of Trauma and Orthopedic Surgery, BG Trauma Center Ludwigshafen, Ludwigshafen, Germany; 3Center for Musculoskeletal Surgery, Charité Universitaetsmedizin Berlin, Berlin, Germany; 4Eglin Air Force Base, 96th Medical Group, United States Air Force, Eglin, FL, USA; 5The Steadman Clinic, Vail, CO, USACorrespondence: Peter J MillettSteadman Philippon Research Institute, 181 W Meadow Dr, Ste 400, Vail, CO 81657, USATel +1 970 479-5871Email drmillett@thesteadmanclinic.comAbstract: Injuries to the acromioclavicular (AC) joint are common and mostly involve younger, male individuals. Whereas the majority of AC joint dislocations can be treated nonoperatively with a trial of immobilization, pain medication, cryotherapy, and physiotherapy, there are patients that do not respond well to conservative management and may require surgical treatment. Identifying and treating these patients according to the type and chronicity of AC joint dislocation is paramount. To date, a myriad of surgical techniques have been proposed to address unstable AC joint dislocations and are indicative of the uncertainty that exists in optimal management of these injuries. Historically research has focused on the restoration of the coracoclavicular ligament complex. However, recently the importance of the acromioclavicular capsule and ligaments has been emphasized. This review aims to provide the reader with an overview of current treatment strategies and research, as well as future perspectives.Keywords: AC capsule, AC joint, coracoclavicular, reconstruction, stabilization, shoulder surgery