Open AccessHigh degree of consensus achieved regarding diagnosis and treatment of acromioclavicular joint instability among ESA‐ESSKA members
Author(s) -
Rosso Claudio,
Martetschläger Frank,
Saccomanno Maristella F.,
Voss Andreas,
Lacheta Lucca,
Ângelo Ana Catarina,
Antonogiannakis Emmanuel,
Azevedo Clara,
Bak Klaus,
Becirbegovic Semin,
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,
Lorbach Olaf,
Maben Benjo,
Marjanovic Benjamin,
Martetschlaeger Frank,
Yiannakopolus Christos,
Ostermann Roman C,
Panagopoulos Andreas,
Papadopoulos Perikles,
Poberaj Boris,
Saccomanno Maristella Francesca,
Smolen Daniel,
Soler Francesc,
Taverna Ettore,
Toussaint Bruno,
Vavken Patrick,
Zurita Nestor,
Beitzel Knut,
Milano Giuseppe
Publication year - 2021
Publication title -
knee surgery, sports traumatology, arthroscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.806
H-Index - 125
eISSN - 1433-7347
pISSN - 0942-2056
DOI - 10.1007/s00167-020-06286-w
Subject(s) - acromioclavicular joint , medicine , delphi method , coracoclavicular ligament , conservative treatment , physical therapy , surgery , artificial intelligence , computer science
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.