What is acromioclavicular arthropathy?

Acromioclavicular arthropathy corresponds to degenerative or post-traumatic involvement of the acromioclavicular joint, source of localized pain at the top of the shoulder.

Favoring factors include repetitive load activities, age, and possible association with subacromial impingement. This pathology can significantly impact quality of life and professional activities.

Pathophysiology and favoring factors

Degenerative wear

Progressive wear of the AC joint with osteophyte formation and articular cartilage degradation.

Repeated microtrauma

Work or sports above the head, repeated stress on the acromioclavicular joint.

Subacromial impingement

May coexist with subacromial impingement, creating a complex clinical picture.

Symptoms and manifestations

Pain

Pain localized above the shoulder, particularly on palpation of the acromioclavicular joint. Pain may radiate to the trapezius and be aggravated during overhead movements.

Characteristics: Often chronic pain, aggravated by load activities and arm elevation movements.

Functional discomfort

Limitation of overhead movements, difficulties during professional or sports activities requiring arm elevation.

Impact: Reduction in quality of life and performance in daily and professional activities.

Diagnosis and evaluation

Clinical examination

• Palpation: Pain on direct palpation of the AC joint
• Specific tests: Cross-body compression test, horizontal adduction test
• Functional assessment: Limitation of elevation and abduction movements

Imaging examinations

Targeted X-rays

Reference examination showing joint space narrowing, osteophytes and deformations

Ultrasound

Minimally invasive examination to assess inflammation and soft tissue lesions

MRI

Reference examination for complete assessment and surgical planning

Therapeutic options

Conservative treatment

Conservative treatment is always preferred as first intention and can be effective in many cases.

• Rest and activity modification: Avoid painful movements
• Rehabilitation: Physiotherapy to improve mobility and strength
• Medications: Anti-inflammatories and analgesics as needed
• Injections: Corticosteroid injection into the AC joint

Surgical treatment

Arthroscopic lateral clavicle resection is indicated in case of failure of well-conducted conservative treatment.

Surgical indications:

• Persistent AC pain despite ≥ 3–6 months of conservative treatment
• Significant functional discomfort in manual workers/athletes
• Failure or recurrence after injections

Lateral clavicle resection

Intervention performed under arthroscopy allowing removal of the lateral part of the clavicle responsible for conflicts. This technique preserves ligaments and minimizes complication risks.

Advantages: Minimally invasive technique, rapid recovery, excellent functional results.

Post-operative rehabilitation

Rehabilitation after lateral clavicle resection is essential to optimize functional recovery and prevent complications.

Phase 1: Immobilization (1-2 weeks)

Comfort sling, gentle immediate mobilization respecting pain

Phase 2: Active mobilization (2-4 weeks)

Progressive shoulder mobilization in all directions without forcing

Phase 3: Strengthening (4-8 weeks)

Progressive strengthening of shoulder muscles and return to activities

Return times: Manual and sports activities: 6–8 weeks depending on pain and recovery.

Possible complications