Case-based Approach to the Management of AC Joint Injuries – An International Perspective (2021 Annual Meeting)-Case-based Approach to the Management of AC Joint Injuries

Case-based Approach to the Management of AC Joint Injuries - An International Perspective-Arce

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Video Summary

Twelve years ago, the iSACOS shoulder committee began addressing acromioclavicular (AC) joint disorders, evolving surgical techniques from high-failure arthroscopic reconstructions to improved methods. Acute AC joint dislocations, defined as injuries less than one week old, present a prime opportunity for surgical intervention. The committee emphasized distinguishing stable (3A) and unstable (3B) grade 3 dislocations to guide treatment, factoring in sport type, season timing, work demands, and cosmetic concerns. Modern surgery uses precise anatomical knowledge, thinner drill bits, and robust implants like internal braces combined with tendon allografts to enhance stability and reduce failure. Key advancements include passing grafts to address posterior instability and utilizing double-suture configurations for intrinsic ligament repair in severe cases. Follow-ups involve x-rays and functional scoring. Results on 26 patients showed notable success with minimal failures. The current consensus is that early surgical repair in appropriate patients yields better outcomes, minimizing complications that plagued earlier techniques.

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Dr. Guillermo Arce

Keywords

Acromioclavicular joint disorders

Acute AC joint dislocations

Surgical techniques

Internal brace and tendon allograft

Grade 3 AC dislocation treatment