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-Romeo

Video Transcription

Video Summary

The presentation discusses chronic acromioclavicular (AC) joint injuries and their surgical management. Despite varied opinions in literature, the speaker emphasizes anatomic reconstruction focusing on addressing not only the coracoclavicular (CC) ligaments but also the often-overlooked AC joint capsule and the deltotrapezial fascia to control rotational instability. The traditional Rockwood classification is deemed insufficient alone for surgical decisions; functional impairment and scapular dyskinesia provide better guidance. Acute reconstruction is rare and generally reserved for specific athletes or severe cases. The speaker favors preserving the distal clavicle to maintain joint biomechanics and stresses careful graft placement for optimal clavicular positioning. Surgical techniques involve autograft loops around the coracoid and clavicle, reinforced with soft-tissue repair and fixation to the acromion to minimize rotational deformity. Postoperatively, immobilization is critical, with gradual rehab over months. Long-term results are promising with low complications, though challenges remain in perfecting rotational stability and preventing hardware-related issues such as coracoid fractures. This approach offers a durable solution, including for revision cases.

Asset Caption

Dr. Anthony Romeo

Keywords

chronic acromioclavicular joint injuries

anatomic reconstruction

coracoclavicular ligaments

rotational instability

Rockwood classification limitations

surgical management techniques