Acromioclavicular joint rupture and stabilisation

The acromioclavicular is the joint that makes the junction between the end of the clavicle and part of the scapula (the acromion).  Acromioclavicular joint injury occurs most commonly due a fall on the shoulder or in contact sports from a laterally directed force resulting in sprain or tear of the ligaments. Low grade injuries can be treated without surgery. 

An important concept in treatment of high grade AC joint instability is achieving multiplanar stability in superoinferior, anteroposterior,and mediolateral directions around the joint after surgical treatment to allow for healing in an anatomic position. After an instability episode of the AC joint, structures that are disrupted include the delto-trapezial fascia, AC joint capsule, CC ligaments, and in some cases the trapezius muscle itself.

Dr McBride utilises a technique to reconstruct and reinforce the torn stabilising ligaments of the ac joint that addresses the multiplanar instability created by the primary injury.   This technique has been shown to have a high patient satisfaction in both amateur and professional athletes with low complication rates.  This technique  has also been used successfully over the last ten years to treat professional AFL players with a mean return to competitive play at 8 and a half weeks. 

1: Borbas P, Warby S, Yalizis M, Smith M, Hoy G. Return to Play After Surgical Treatment of High-Grade Acromioclavicular Joint Injuries in the Australian Football League. Orthop J Sports Med. 2022 Apr 6;10(4):23259671221085602. doi: 10.1177/23259671221085602. PMID: 35400140; PMCID: PMC8990692.

2;Hoy, Gregory & Yalizis, Matthew & Smith, Mitchell & Anderson, Hamish & Warby, Sarah. (2019). Reconstruction of the Acromioclavicular Joint With 360-degree Control. Techniques in Shoulder & Elbow Surgery. 20. 96-103. 10.1097/BTE.0000000000000167.