Treating chronic instability of the acromioclavicular joint

Abstract

The acromioclavicular joint is the link between the collarbone and the scapula, responsible for synchronizing movements in the upper shoulder girdle. Chronic instability of the acromioclavicular joint leads to changes in the orientation of the scapula, which provokes kinematic disorders leading to chronic pain. In case of acute dislocation of the acromial end of the clavicle, minimally invasive techniques are usually used, such as fixation with spokes or a hook-shaped plate, or arthroscopic fixation. Surgical techniques for the treatment of patients with acromioclavicular joint chronic symptomatic instability differ significantly from those used to treat patients with acute dislocation of the acromioclavicular joint. In this case, reconstruction of torn ligaments is necessary, because the biological potential of restoring these structures is exhausted after 3–4 weeks. The range of possibilities includes anatomical and non-anatomical techniques, open and minimally invasive procedures using arthroscopy, as well as biological and synthetic transplants. This article presents the authors’ approach to treating such patients and describes the modern reliable surgical technique.