Acromioclavicular joint pathology in athletes

Acromioclavicular (AC) joint injuries are common in competitive and recreational athletes. These injuries are a significant cause of pain and instability, especially with overhead activities. Injuries are generally classified using the Rockwood Classification system, based on the degree of ligamentous injury to the AC joint and the coracoclavicular (CC) ligaments. In general, Rockwood type I and II injuries are managed nonoperatively, while types IV and VI are usually treated surgically. However, there is debate on the optimal treatment of type III and V injuries. Various surgical techniques have been described, including reconstruction with internal fixation, coracoacromial ligament transfer, reconstruction with suture fixation, anatomic coracoclavicular ligament reconstruction (ACCR), and arthroscopic-assisted techniques. The current review article describes the diagnosis and therapy of this injury with regard to the athlete and additionally presents the differences in treatment approaches between the United States and Germany (Europe).