Acromioclavicular joint injuries: evidence-based treatment

Review written by Dr Angela Cadogan info

Key Points

  1. Type I and II acromioclavicular (AC) joint injuries may not be as benign as previously thought, with symptoms and dysfunction often continuing for months or years.
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Acromioclavicular (AC) joint injuries are common in young athletes, often resulting from a fall onto the point of the shoulder. Injuries have typically been classified radiologically using the Rockwood classification system that grades the injury according to the degree and direction of displacement of the distal clavicle.

Historically, injury classification has been used to guide treatment: Types I and II are commonly managed non-surgically; Types IV and VI are commonly managed surgically; debate continues about the best management for Types III and V. This paper examined decision-making principles and treatment options for AC joint injuries.

AC joint injuries have typically been classified radiologically using the Rockwood classification system.
Some studies have reported that treatment decisions for AC joint injury should be made based on symptoms and function rather than radiologic classification.


The authors provided a narrative review of the literature covering AC joint anatomy, biomechanics, classification, clinical examination features, diagnostic imaging and treatment options for Type I to VI injuries. They also provided a description of various surgical techniques describing the

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