AOSSM/AANA Specialty Day 2020-The Unstable AC Joint-Fixing and Avoiding Complications

Video Transcription

Video Summary

Steve Brockmeyer from the University of Virginia discusses the management of unstable acromioclavicular (AC) joint injuries, focusing on surgical repair and complication avoidance. He reviews injury classification, emphasizing that most low-grade separations (type 1-2) are treated non-surgically, while surgery is considered for higher grades (type 4-5) and some unstable type 3 injuries, especially in high-demand patients. Brockmeyer advocates for acute surgical intervention when indicated, highlighting the importance of addressing both the coracoclavicular (CC) ligaments and the AC joint capsule to improve stability and reduce failure risk. His preferred technique avoids drilling the coracoid and minimizes clavicle trauma, using fiber tapes, grafts, and AC ligament repair. Postoperative care involves strict immobilization for six weeks, followed by progressive rehabilitation, delaying full return to contact sports up to six months. He shares outcome data favoring combined AC and CC reconstruction over isolated CC repair. Brockmeyer emphasizes individualized treatment decisions and cautious rehabilitation to optimize patient outcomes.

Keywords

unstable acromioclavicular joint

surgical repair

injury classification

coracoclavicular ligaments

postoperative rehabilitation

AC and CC reconstruction