Aktuelle Versorgungsstrategien bei Schultereckgelenkinstabilitäten

Abstract

Injuries of the acromioclavicular joint are common in clinical daily routine. Rockwood (RW) I and II lesions are treated non-operatively. The ideal treatment for RW III lesions is still controversially discussed. RW IV-VI injuries require operative treatment. New findings emphasize the importance of a horizontal component of instability at the RW III injury, which should be integrated into the medical advice for an operative or non-operative treatment and the operative concept. During recent years arthroscopically-assisted techniques have become established for repair of acute as well as chronic instabilities. In acute lesions very good clinical results can be archived with fixation techniques using endobutton systems. In cases of chronic instability, options include anatomic reconstruction of the ligamentous structures with a tendon autograft augmented by an endobutton system as well as transposition techniques of the coracoacromial ligament. © 2012 Springer-Verlag Berlin Heidelberg.