The role of the acromioclavicular joint in impingement syndrome

Acromioclavicular pathology usually represents a late manifestation of supraspinatus outlet impingement and presents as a source of pain that is resistant to measures designed to treat purely anterior acromial pathology. Although nonoperative measures are indicated for initial treatment, operative intervention may be necessary in cases of advanced acromioclavicular joint degeneration, particularly when distally projecting osteophytes are present. Depending on the degree of degenerative changes, surgery to address acromioclavicular impingement may include distal clavicular resection, beveling of the acromioclavicular joint, or excision of marginal osteophytes. The results of surgery are generally favorable, although controversy exists concerning the role of coplaning of the acromioclavicular joint.