High degree of consensus achieved regarding diagnosis and treatment of acromioclavicular joint instability among ESA-ESSKA members
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Published:2020-09-26
Issue:7
Volume:29
Page:2325-2332
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ISSN:0942-2056
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Container-title:Knee Surgery, Sports Traumatology, Arthroscopy
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language:en
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Short-container-title:Knee Surg Sports Traumatol Arthrosc
Author:
Rosso ClaudioORCID, Martetschläger FrankORCID, Saccomanno Maristella F.ORCID, Voss AndreasORCID, Lacheta LuccaORCID, Ângelo Ana Catarina, Antonogiannakis Emmanuel, Azevedo Clara, Bak Klaus, Becirbegovic Semin, Beitzel KnutORCID, Bilsel Kerem, Brzoska Roman, Calvo Angel, Charousset Christophe, Dyrna Felix, Brilakis Emmanuel, Franceschi Francesco, Glasson Jean Marc, Gleyze Pascal, Gomes Nuno, Hackney Roger, Hantes Michael, Karargyris Orestis, Karahan Mustafa, Kovacic Ladislav, Kubashev Alexander, Lacheta LuccaORCID, Lorbach Olaf, Maben Benjo, Marjanovic Benjamin, Martetschlaeger Frank, Yiannakopolus Christos, Ostermann Roman C, Panagopoulos Andreas, Papadopoulos Perikles, Poberaj Boris, Rosso ClaudioORCID, Saccomanno Maristella Francesca, Smolen Daniel, Soler Francesc, Taverna Ettore, Toussaint Bruno, Vavken Patrick, Voss AndreasORCID, Zurita Nestor, Beitzel KnutORCID, Milano GiuseppeORCID,
Abstract
Abstract
Purpose
To develop a consensus on diagnosis and treatment of acromioclavicular joint instability.
Methods
A consensus process following the modified Delphi technique was conducted. Panel members were selected among the European Shoulder Associates of ESSKA. Five rounds were performed between October 2018 and November 2019. The first round consisted of gathering questions which were then divided into blocks referring to imaging, classifications, surgical approach for acute and chronic cases, conservative treatment. Subsequent rounds consisted of condensation by means of an online questionnaire. Consensus was achieved when ≥ 66.7% of the participants agreed on one answer. Descriptive statistic was used to summarize the data.
Results
A consensus was reached on the following topics. Imaging: a true anteroposterior or a bilateral Zanca view are sufficient for diagnosis. 93% of the panel agreed on clinical override testing during body cross test to identify horizontal instability. The Rockwood classification, as modified by the ISAKOS statement, was deemed valid. The separation line between acute and chronic cases was set at 3 weeks. The panel agreed on arthroscopically assisted anatomic reconstruction using a suspensory device (86.2%), with no need of a biological augmentation (82.8%) in acute injuries, whereas biological reconstruction of coracoclavicular and acromioclavicular ligaments with tendon graft was suggested in chronic cases. Conservative approach and postoperative care were found similar
Conclusion
A consensus was found on the main topics of controversy in the management of acromioclavicular joint dislocation. Each step of the diagnostic treatment algorithm was fully investigated and clarified.
Level of evidence
Level V.
Funder
University of Basel
Publisher
Springer Science and Business Media LLC
Subject
Orthopedics and Sports Medicine,Surgery
Reference29 articles.
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