Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Acromioclavicular Joint”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources
PubMed1995

A comparison of the methods of distraction for stress examination of the acromioclavicular joint.

Acromioclavicular joint disruption is frequently evaluated with a radiographic examination of the joint under stress (weight bearing). Certain authors recommend suspending the weights from the arm, rather than being hand-held, to allow for total muscle relaxation. This study examines the relationship between the coracoclavicular distance measured and the method of distraction. 30 normal subjects participated in the study which used ultrasound (5 MHz linear array) to measure the coracoclavicular distance under four conditions (levels of traction): non-stressed, muscles relaxed; non-stressed, muscles tensed; stressed with 7.5 kg weight hand held; stressed with 7.5 kg weight suspended from the wrist. The data were subjected to a multifactor ANOVA. The level of traction was statistically significant (p < 0.001). The data were then subjected to a Bonferroni multiple comparisons procedure. This showed a difference between the non-stressed and stressed conditions, but there was no difference between the two methods of applying stress to the joint. It was concluded that, in normal subjects, the method of performing the weight bearing examination does not have a significant effect on the magnitude of the coracoclavicular distance.

Acromioclavicular Joint↗
PubMed1995

Acromioclavicular joint injuries.

Acromioclavicular joint injuries, including sprains and dislocations, are common shoulder problems treated by orthopaedic surgeons. The classification of acromioclavicular joint injuries comprises six grades, according to the degree of ligamentous disruption and displacement. Grades I and II are generally treated nonoperatively, whereas types IV, V, and VI are treated surgically. Treatment for grade III injuries remains controversial. Fractures of the distal aspect of the clavicle have been divided into three types. Type I fractures are stable and require brief immobilization. Type II fractures are unstable and require surgical fixation. Type III fractures often require late surgery for acromioclavicular arthritis.

Acromioclavicular Joint↗
PubMed1983

Radiographic joint space in normal acromioclavicular joints.

The acromioclavicular joint space in standard antero-posterior images of 151 normal subjects was measured. The joint space was significantly wider in men. There was a highly significant reduction of the joint space with age in both men and women and in persons past 60 a joint space of 0.5 mm or less is not pathological. A joint space wider than 7 mm in men and 6 mm in women is abnormal. The measuring technique described is useful in population studies. In individual cases a simple measurement with a ruler serves the same purpose.

Acromioclavicular Joint↗
PubMed2004

Disorders of the acromioclavicular joint.

The acromioclavicular joint is a frequent source of shoulder pain.This article reviews acromioclavicular separations and other disorders affecting the joint and its surrounding structures.

Acromioclavicular Joint↗
PubMed1999

Radiographic joint space in rheumatoid acromioclavicular joints: a 15 year prospective follow-up study in 74 patients.

OBJECTIVE: To evaluate radiographically the acromioclavicular joint space in patients with long-term rheumatoid arthritis (RA). METHODS: A cohort of 74 patients with RA was followed prospectively for 15 yr. At the end point, 148 shoulders were radiographed with a standard method. The acromioclavicular (AC) joint space was examined from the radiographs with a method developed previously for population studies; the joint space was measured at its superior and inferior border, and the average of the two measurements, the integral space, calculated. RESULTS: Mean AC joint space in RA patients was 4.9 (S.D. 3.7), range 0-20.5 mm; 6.2 mm (S.D. 5.1) in men and 4.5 mm (S.D. 3. 0) in women. An AC joint space wider than 7 mm in men was found in 11 (31%) out of 36 joints and wider than 6 mm in women in 17 (15%) out of 112 joints. Joint space widening was associated (r=0.87, 95% CI 0.82-0.90) with increasing destruction (Larsen grading) of the joint and it seems to be an inevitable consequence of AC joint affection in RA. Joint space widening is more progressive on the caudal side because of the nature of the erosive destruction. Degeneration with joint space narrowing was observed in 8 (11%) patients (11 joints, 7%; three bilateral). CONCLUSIONS: The largest value of the joint space may be used when evaluating rheumatoid AC joint space. In RA patients, a joint space of >7 mm in men and >5 mm in women is a sign of destructive AC joint affection.

Acromioclavicular Joint↗
PubMedDate not supplied

Lateral roentgenographic projections of the acromioclavicular joint.

Although the acromioclavicular joint is frequently injured in both contact and noncontact sports, the treatment is nonspecific, as demonstrated by the numerous methods of treatment currently employed. Despite treatment, some shoulders still develop chronic symptoms and disability during overhead lifting, throwing, and swinging. Perhaps these difficulties develop as a result of an incomplete evaluation of the joint and because the exact nature of the injury is not appreciated. Therefore, the shoulder develops chronic problems. We have routinely utilized a lateral roentgenogram of the acromion to evaluate the acromioclavicular joint. This has significantly aided us in the diagnosis and treatment of acromioclavicular joint injuries, especially when there was posterior dislocation of the distal clavicle. This presentation reviews standard roentgenography of the acromioclavicular joint and illustrates the method of obtaining the lateral projection as described by O. M. Alexander. We will also show how this method has helped us clinically in detecting posterior dislocations of the distal end of the clavicle.

Accidents, Traffic↗
PubMed2004

Osteoarthritis of the acromioclavicular joint: a review of anatomy, biomechanics, diagnosis, and treatment.

Shoulder pain is a frequent presenting complaint to physiatrists. Commonly encountered pathogeneses include rotator cuff pathology, bursitis, biceps tendonitis, and labral tears. Because the majority of shoulder pain originates within the subacromial region and the glenohumeral joint, the acromioclavicular, sternoclavicular, and scapulothoracic articulations may be overlooked. Osteoarthritis of the acromioclavicular joint is a common source of shoulder pain that is often neglected by clinicians and researchers. The proper diagnosis of acromioclavicular joint osteoarthritis requires a thorough physical exam, plain-film radiograph, and a diagnostic local anesthetic injection. Current treatment options are rather limited. Initial therapies are similar to that of osteoarthritis in other joints and include oral analgesics or anti-inflammatories and an emphasis on activity modification. Physical therapy, unfortunately, has little to offer, as therapeutic exercise and range of motion play only a minor role. If a diagnostic local anesthetic injection provides relief, there may be a role for corticosteroid injections. It seems that the administration of local corticosteroids into the acromioclavicular joint may provide short-term pain relief. The judicious administration of such injections remains controversial, and most experts agree that steroid injections do not alter the natural progression of the disease. Surgical options, indicated typically after a minimum of 6 mos of unsuccessful conservative treatment consist of open or arthroscopic distal clavicle resection.

Acromioclavicular Joint↗
PubMed2006

Arthroscopically assisted acromioclavicular joint reconstruction.

Arthroscopically assisted acromioclavicular joint reconstruction avoids the large incisions necessary with open reconstructions. This acromioclavicular joint reconstruction technique via the subacromial space does not violate the rotator interval or require screw removal. The patient is placed in a modified beach-chair position. The arthroscope is placed into the subacromial space, and a bursectomy is performed through a lateral subacromial portal. The coracoacromial ligament is released from the acromion with an electrocautery and an arthroscopic elevator. A nonabsorbable suture is passed through the coracoacromial ligament with a suture passer, and an arthroscopic suture grasper is used to deliver both ends of the suture out through the lateral portal. The coracoid is identified and isolated using a radiofrequency ablator placed through the anterior portal while visualizing through the lateral portal. A percutaneous shuttle device is passed through the skin superomedial to the coracoid. The shuttle is visualized entering superior to the coracoid and is passed just medial to the coracoid. Once the tip of the shuttle can be visualized in the recess inferior to the coracoid, the shuttle loop is advanced. A suture grasper is used to deliver both ends of the shuttle out through the anterior portal. A semitendinosus allograft is used to reconstruct the coracoclavicular ligament. A nonabsorbable suture is passed through both ends of the allograft. Three strands of nonabsorbable suture are braided together. The tendon and the braided suture are shuttled around the coracoid. At this point, both the braided suture and the allograft tendon enter the anterior portal, wrap around the coracoid base, and exit the anterior portal. A 3-cm incision is made over the distal clavicle. A hole is drilled through the clavicle with a 5-mm drill. A loop of 22-gauge wire is passed through the hole in the clavicle, and a looped suture is shuttled through the hole. A curved clamp is used to create a tunnel from the acromioclavicular joint, under the deltoid, to the anterior portal. The ends of the braided suture and the tendon sutures are grasped by the clamp and pulled out the acromioclavicular joint incision. The limbs of the braided suture and the tendon suture that pass medial to the coracoid are shuttled through the hole in the clavicle using the looped suture that was previously passed through the clavicle. The acromioclavicular joint is reduced by pushing down on the distal clavicle with a bone tamp while simultaneously lifting the acromion upward by superiorly loading the humerus at the elbow. Once the acromioclavicular joint is reduced or slightly over-reduced, the braided suture is tied down securely. The acromioclavicular joint should remain reduced even after the manual reduction maneuver is released. The semitendinosus allograft is tensioned around the distal end of the clavicle and sutured to itself with a nonabsorbable suture. The released coracoacromial ligament is retrieved from the clavicular incision and sutured to the distal clavicle and semitendinosus allograft. The incision is closed in standard fashion, and a sling is applied.

Acromioclavicular Joint↗
PubMedDate not supplied

Painful conditions of the acromioclavicular joint.

The acromioclavicular (AC) joint may be affected by a number of pathologic processes, most commonly osteoarthritis, posttraumatic arthritis, and distal clavicle osteolysis. The correct diagnosis of a problem can usually be deduced from a thorough history, physical examination, and radiologic evaluation. Asymptomatic AC joint degeneration is frequent and does not always correlate with the presence of symptoms. Selective lidocaine injection enhances diagnostic accuracy and may correlate with surgical outcome. Nonoperative treatment is helpful for most patients, although those with osteolysis may have to modify their activities. In appropriately selected patients, open or arthroscopic distal clavicle resection is necessary to relieve symptoms. Recent biomechanical and clinical data emphasize the importance of capsular preservation and minimization of bone resection; however, the optimal amount of distal clavicle resection remains elusive. Patients with AC joint instability have poor results after distal clavicle resection.

Acromioclavicular Joint↗
PubMed1991

[Surgical treatment of acromioclavicular joint injury].

The acromioclavicular joint plate according to Rahmanzadeh allows the safe retention of the reset acromioclavicular joint in stage Tossy III and in exceptional cases also in stage Tossy II traumata when simultaneous early functional post-treatment is done from the first postoperative day on. The clinical results obtained after follow-up examinations of 53 of the 83 patients treated in this way were mostly good or very good. Perfect radiological results were obtained in 50% of these patients; 40% showed a slight subluxation and 10% a marked but pain-free subluxation.

Acromioclavicular Joint↗
PubMed1994

Localization of the acromioclavicular joint.

Localizing the acromioclavicular joint can be difficult. Using bony landmarks--the clavicle and the spine of the scapula--the acromioclavicular joint can be consistently localized for physical examination, injections, and surgery.

Acromioclavicular Joint↗
PubMed1998

Acromioclavicular joint disorders.

The acromioclavicular joint is commonly involved in athletic injuries. Most commonly, a sprain to the joint occurs with variability in the amount of ligamentous damage and displacement that occurs. In all but the most severe dislocations, treatment consists of initial sling immobilization and early functional rehabilitation. The outcome is usually excellent with full return of function following these injuries. The rarer types (IV, V, and VI) require operative reduction and fixation. Distal clavicle fractures are related injuries, which many times disrupt the stabilizing ligaments of the acromioclavicular joint. Many can be treated nonoperatively, but there are several subtypes that should be considered for early fixation to reduce complications of pain and shoulder dysfunction. An atraumatic, overuse condition, which is becoming more prevalent and seems related to weight training, is osteolysis of the distal clavicle. There is insidious onset of shoulder pain with symptoms and signs consistent with acromioclavicular pathology. Activity modification is the best method of controlling symptoms. Failure of the conservative approach necessitates operative excision of the distal clavicle.

Acromioclavicular Joint↗
PubMed2005

Anatomical acromioclavicular ligament reconstruction: a biomechanical comparison of reconstructive techniques of the acromioclavicular joint.

BACKGROUND: Current surgical treatments for acromioclavicular separations do not re-create the anatomy of the acromioclavicular joint. HYPOTHESIS: Anatomical acromioclavicular reconstruction re-creates the strength of the native acromioclavicular joint and is stronger than a modified Weaver-Dunn repair. STUDY DESIGN: Controlled laboratory study. METHODS: The native acromioclavicular joint in 6 fresh-frozen cadaveric upper extremities was stressed to failure under uniaxial tension in the coronal plane. A modified Weaver-Dunn procedure, anatomical acromioclavicular reconstruction using a palmaris longus graft, and anatomical acromioclavicular reconstruction using a flexor carpi radialis graft were then performed sequentially. Each repair was stressed to failure. Load-displacement curves and mechanism of failure were recorded for each. RESULTS: Loads at failure for the native acromioclavicular joint complex, modified Weaver-Dunn procedure, anatomical acromioclavicular reconstruction using a palmaris longus tendon graft, and anatomical acromioclavicular reconstruction using a flexor carpi radialis tendon graft were 815 N, 483 N, 326 N, and 774 N, respectively. The strength of the native acromioclavicular joint complex was significantly different from the modified Weaver-Dunn repair (P < .001) and the anatomical acromioclavicular reconstruction using a palmaris longus tendon graft (P < .001) but not from the anatomical acromioclavicular reconstruction using a flexor carpi radialis tendon graft (P = .607). CONCLUSION: The strength of the described anatomical acromioclavicular reconstruction is limited by the tendon graft used. Anatomical acromioclavicular reconstruction with a flexor carpi radialis tendon graft re-creates the tensile strength of the native acromioclavicular joint complex and is superior to a modified Weaver-Dunn repair.

Acromioclavicular Joint↗
PubMed1992

[Athletic capacity after surgical management of acromioclavicular joint separation].

Acromioclavicular separation is a common injury in sports. This study was done to show the activity and problems of athletes after operative treatment of this kind of injury. Between 1986 and 1989 21 athletes with acromioclavicular separation had been treated by operation. The coracoclavicular ligaments had been sutured and augmented by a PDS cord. The acromioclavicular ligaments had also been reattached and the ac-joint had been transfixed with a Kirschner-wire. The results show 18 athletes doing their sports on the same level as preoperatively. Two athletes with a frequency of sporting activity once a week could not continue their sporting activity. One athlete changed the disciplines to less shoulder stressing kind of sport. The comparison of clinical and radiological results showed no correlation, even patients with an osteoarthrosis of the ac-joint and coracoclavicular ossifications had best clinical results. We recommend therefore operative treatment for acromioclavicular separation in athletes.

Acromioclavicular Joint↗
PubMed2004

Evaluation and management of acromioclavicular joint injuries.

The acromioclavicular joint is stabilized by the coracoclavicular and acromioclavicular ligaments and by the trapezius and deltoid muscles. Joint dislocation commonly results from a direct blow to the acromion. Injury types I through III are generally treated nonoperatively, whereas types IV through VI are treated operatively. Nonoperative protocols should always begin with ice and immobilization. Operative techniques include acromioclavicular ligament repair, dynamic transfer of the conjoined tendon, coracoclavicular ligament reconstruction, and coracoacromial ligament transfer. The goal with any injury type should always be full return to the patient's preinjury condition.

Acromioclavicular Joint↗
PubMedDate not supplied

The active compression test: a new and effective test for diagnosing labral tears and acromioclavicular joint abnormality.

Labral tears and acromioclavicular joint abnormalities were differentiated on physical examination using a new diagnostic test. The standing patient forward flexed the arm to 90 degrees with the elbow in full extension and then adducted the arm 10 degrees to 15 degrees medial to the sagittal plane of the body and internally rotated it so that the thumb pointed downward. The examiner, standing behind the patient, applied a uniform downward force to the arm. With the arm in the same position, the palm was then fully supinated and the maneuver was repeated. The test was considered positive if pain was elicited during the first maneuver, and was reduced or eliminated with the second. Pain localized to the acromioclavicular joint or "on top" was diagnostic of acromioclavicular joint abnormality, whereas pain or painful clicking described as "inside" the shoulder was considered indicative of labral abnormality. A prospective study was performed on 318 patients to determine the sensitivity, specificity, and positive and negative predictive values of the test. Fifty-three of 56 patients whose preoperative examinations indicated a labral tear had confirmed labral tears that were repaired at surgery. Fifty-five of 62 patients who had pain in the acromioclavicular joint and whose preoperative examinations indicated abnormalities in the joint had positive clinical, operative, or radiographic evidence of acromioclavicular injury. There were no false-negative results in either group.

Acromioclavicular Joint↗
PubMed1997

An intra-articular fracture-dislocation of the acromioclavicular joint.

A hybrid acromioclavicular joint fracture-dislocation in which an intra-articular fracture of the distal clavicle coexisted with a coracoclavicular ligament injury is described. The proposed mechanism of injury is a fall on the point of the shoulder that simultaneously drives the scapula both anteriorly and inferiorly. Forced anterior scapular protraction caused a displaced horizontal plane fracture of the inferior half of the distal clavicle, which was separated from the remainder of the clavicle. The inferiorly acromioclavicular ligament was still attached to this distal clavicle fragment. The inferiorly directed force ruptured the coracoclavicular and superior acromioclavicular ligaments.

Acromioclavicular Joint↗
PubMed2004

Magnetic resonance imaging of the coracoclavicular ligaments: its role in defining pathoanatomy at the acromioclavicular joint.

Four patients with acromioclavicular joint injuries (one type II, two type III, one type V), two patients without acromioclavicular joint injury, and a fresh-frozen cadaver underwent magnetic resonance imaging (MRI) and plain radiographs. The normal conoid and trapezoid ligaments were easily identified in the cadaver and the two uninjured patients. Magnetic resonance imaging revealed disruption of both coraclavicular ligaments in the three patients with type II and type III injuries. However, the patient with the type V injury had disruption of the trapezoid ligament alone. Thus, the grade of injury, as determined by the change in the coracoclavicular interval onplain radiography and defined by the Rockwood classification system, failed to correlate with the pathoanatomy seen on MRI in two of the four injured patients. These findings suggest that improvements in the classification of these injuries may be necessary.

Acromioclavicular Joint↗