Timing in injuries of the acromioclavicular joint How quickly should they be treated?

Background Different information can be found in the literature about the optimal timing of surgery for injuries of the acromioclavicular joint (ACJ). The majority of the available studies suggest surgery within the first 3 weeks as functionally better results were shown compared to delayed surgery. Histological studies suggest that the dynamic healing of the AC ligament complex may be an explanation for this observation. Objective This article presents the current status of the discussion about the optimal time of treatment of ACJ injuries. Material and methods Evaluation of the currently available literature. Results The treatment of an acute dislocation of the ACJ should be performed, whenever possible, within the inflammatory phase (0-7 days after trauma). The regeneration potential of the AC ligament complex (ACLC) appears to be greatest in this phase. After completion of the second week after trauma, augmentation using an autologous tendon graft is usually necessary. The results after treatment of chronic dislocation have greatly improved in recent years. Conclusion In a review by Song et al. treatment is recommended within the first 3 weeks after the trauma; however, the heterogeneity of the surgical techniques reduces the significance of these examinations. The fact that the earliest possible surgical treatment seems to be advantageous could be shown by the histological examination of the AC ligament complex by Maier et al. A randomized controlled study for clinical testing is still not available.