From the Sports Medicine (Dr. Frank), Cartilage Restoration, and Shoulder Surgery, Team Physician, University of Colorado Athletics, the Department of Orthopaedic Surgery (Dr. Frank), University of Colorado School of Medicine, Aurora, CO, the Department of Orthopedics and Rehabilitation, University of Wisconsin School of Medicine and Public Health, Madison, WI (Dr. Cotter), the Department of Orthopaedic Surgery, University of Toronto, Toronto, ON, Canada (Dr. Leroux), and the Sports Medicine/Shoulder Elbow Division, Rothman Institute, New York, New York (Dr. Romeo).
J Am Acad Orthop Surg. 2019 Sep 1;27(17):e775-e788. doi: 10.5435/JAAOS-D-17-00105.
Injuries to the acromioclavicular (AC) joint are common in the athletic patient population. Most AC joint injuries occur in young males, typically from a direct fall onto the superior aspect of the shoulder when the arm is adducted. Numerous publications describing joint anatomy and biomechanics, surgical techniques for reconstruction, and rehabilitation protocols are available to guide treatment strategies for injuries to the AC joint. Treatment is typically nonsurgical for type I and II injuries and surgical for type IV and VI injuries. Controversy surrounds the indications for nonsurgical versus surgical treatment of type III and V injuries. Multiple surgical techniques have been described, including coracoclavicular (CC) screw fixation, coracoacromial ligament transfer, and numerous methods of CC ligament reconstruction. Anatomic CC ligament reconstruction can be performed either open or arthroscopically, with and without graft augmentation. This article will discuss clinically relevant anatomy and biomechanical properties of the AC joint and will review decision-making principles and treatment options for common AC joint injuries. An updated summary of clinical outcomes after AC joint treatment will also be presented.
肩锁关节（AC）损伤在运动患者中很常见。大多数 AC 关节损伤发生在年轻男性，通常是手臂内收时直接摔倒在肩部上方。有许多出版物描述了关节解剖结构和生物力学、重建的手术技术以及康复方案，以指导 AC 关节损伤的治疗策略。对于 I 型和 II 型损伤，通常采用非手术治疗，对于 IV 型和 VI 型损伤，通常采用手术治疗。对于 III 型和 V 型损伤，非手术与手术治疗的适应证存在争议。已经描述了多种手术技术，包括喙锁（CC）螺钉固定、喙肩韧带转移以及 CC 韧带重建的多种方法。解剖 CC 韧带重建可以通过开放或关节镜进行，有和没有移植物增强。本文将讨论 AC 关节的临床相关解剖结构和生物力学特性，并回顾常见 AC 关节损伤的决策原则和治疗选择。还将介绍 AC 关节治疗后临床结果的最新总结。
