title: Management of chronic unstable acromioclavicular joint injuries.
abstract: The acromioclavicular joint represents the link between the clavicle and the scapula, which is responsible for the synchronized dynamic of the shoulder girdle. Chronic acromioclavicular joint instability involves changes in the orientation of the scapula, which provokes cinematic alterations that might result in chronic pain. Several surgical strategies for the management of patients with chronic and symptomatic acromioclavicular joint instability have been described. The range of possibilities includes anatomical and non-anatomical techniques, open and arthroscopy-assisted procedures, and biological and synthetic grafts. Surgical management of chronic acromioclavicular joint instability should involve the reconstruction of the torn ligaments because it is accepted that from three weeks after the injury, these structures may lack healing potential. Here, we provide a review of the literature regarding the management of chronic acromioclavicular joint instability.
  
  
  METHODS
  Expert opinion, Level V.
authors.affiliation: Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Street Sant Quintí 89, 08026, Barcelona, Spain. luisgerardonaterac@gmail.com.|Hospital General de Catalunya, Street Pedro i Pons 1, 08190, Sant Cugat Del Vallés, Barcelona, Spain. luisgerardonaterac@gmail.com.
authors.forename: Luis Natera
authors.identifier: http://orcid.org/0000-0002-1403-192X
authors.initials: LN
authors.lastname: Cisneros
authors.affiliation: Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Street Sant Quintí 89, 08026, Barcelona, Spain.|Hospital Quirón Teknon, Street Vilana 12, 08022, Barcelona, Spain.
authors.forename: Juan Sarasquete
authors.initials: JS
authors.lastname: Reiriz
mesh_terms: D000173:Acromioclavicular Joint / Q000293:injuries* / Q000601:surgery*; D001182:Arthroscopy; D002908:Chronic Disease; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery*; D007593:Joint Instability / Q000601:surgery*; D008023:Ligaments, Articular / Q000601:surgery
keywords: Anatomical ligament reconstruction; Arthroscopically assisted management; Chronic setting; Coracoclavicular ligaments; Scapular dyskinesis; Unstable acromioclavicular joint injuries