APEX Shoulder Mastering Surgical Techniques for Clinical Success-Shoulder AC Joint

Video Transcription

Video Summary

The panel discusses management of AC joint separations, ranging from acute to chronic cases. They review radiographic assessment, highlighting the significance of coracoclavicular distance and ossifications affecting reduction. The discussion emphasizes conservative treatment initially, especially for grades 3 and 5 injuries, with surgery reserved for cases with instability, severe symptoms, or failure of physical therapy. Surgical techniques vary, including arthroscopic and open approaches for coracoclavicular ligament reconstruction using grafts (typically allografts), with fixation involving tunnels and interference screws. They note the technical challenges of chronic cases, especially with ossification or prior bone loss, and the importance of removing heterotopic ossification to allow reduction. Postoperative protocols include sling immobilization and gradual motion. The group also reviews a complex sternoclavicular joint nonunion case, demonstrating osteotomy and oblique tunnel fixation to restore stability. Overall, treatment decisions are individualized, balancing patient symptoms, activity level, and radiographic findings.

Asset Caption

Moderator: Xinning Li, M.D.
Panel: Alberto Guevara, M.D., Ganesh Kamath M.D., Colten Luedke, D.O.

Keywords

AC joint separations

coracoclavicular distance

conservative treatment

coracoclavicular ligament reconstruction

heterotopic ossification

sternoclavicular joint nonunion