Zusammenfassung
Die Arthrose des Schultereckgelenks ist eine häufige Ursache anterosuperiorer Schulterschmerzen. Morphologische Veränderungen sind bereits in der 2.–3. Lebensdekade zu sehen. Symptome treten meist im mittleren Alter als Folge repetitiver Überkopfbeanspruchungen auf. Die Diagnose beruht auf der Anamnese, strukturierter körperlicher Untersuchung und zielgerichteter Bildgebung. Angesichts der mangelnden Spezifität körperlicher Untersuchungsergebnisse, der unterschiedlichen Natur von acromioclaviculären Gelenkschmerzen sowie konkurrierender Pathologien des Schultergelenks kann die korrekte Diagnosefindung schwierig sein. Obwohl verschiedene bildgebende Techniken zum Teil frühzeitig eine Degeneration aufzeigen können, kann die Diagnose nicht allein darauf beruhen, da ähnliche Befunde bei asymptomatischen Individuen zu sehen sind. In der Behandlung stellen nichtoperative Maßnahmen die initiale Therapie dar und können eine Linderung der Symptome bringen. Patienten mit anhaltenden Beschwerden sollten für die Resektionsarthroplastik durch offene oder arthroskopische Techniken in Betracht gezogen werden.
Similar content being viewed by others
Literatur
Alexander OM (1949) Dislocation of the acromioclavicular joint. Radiography 15(179):260, illust
Amirtharaj MJ, Wang D, McGraw MH, Camp CL, Degen RA, Dines DM, Dines JS (2018) Trends in the surgical management of acromioclavicular joint arthritis among board-eligible US orthopaedic surgeons. Arthroscopy 34(6):1799–1805
Beitzel K, Sablan N, Chowaniec DM, Obopilwe E, Cote MP, Arciero RA, Mazzocca AD (2012) Sequential resection of the distal clavicle and its effects on horizontal acromioclavicular joint translation. Am J Sports Med 40(3):681–685
Boehm TD, Kirschner S, Fischer A (2004) The relation of the coracoclavicular ligament insertion to the acromioclavicular joint: a cadaver study of relevance to lateral clavicle resection. Acta Orthop Scand 74:718–721
Buttaci CJ, Stitik TP, Yonclas PP, Foye PM (2004) Osteoarthritis of the acromioclavicular joint: a review of anatomy, biomechanics, diagnosis, and treatment. Am J Phys Med Rehabil 83(10):791–797
Chronopoulos E, Kim TK, Park HB, Ashenbrenner D, McFarland EG (2004) Diagnostic value of physical tests for isolated chronic acromioclavicular lesions. Am J Sports Med 32(3):655–661
Colegate-Stone T, Allom R, Singh R, Elias DA, Standring S, Sinha J (2010) Classification of the morphology of the acromioclavicular joint using cadaveric and radiological analysis. J Bone Joint Surg Br 92(5):743–746
Depalma AF (1963) Surgical anatomy of acromioclavicular and sternoclavicular joints. Surg Clin North Am 43:1541–1550
Freedman BA, Javernick MA, O’Brien FP, Ross AE, Doukas WC (2007) Arthroscopic versus open distal clavicle excision: comparative results at six months and one year from a randomized, prospective clinical trial. J Shoulder Elb Surg 16(4):413–418
Fukuda K, Craig EV, An KN, Cofield RH, Chao EY (1986) Biomechanical study of the ligamentous system of the acromioclavicular joint. J Bone Joint Surg Am 68(3):434–440
Gurd FB (1941) The treatment of complete dislocation of the outer end of the clavicle: an hitherto undescribed operation. Ann Surg 113(6):1094–1098
Hammel JM, Kwon N (2005) Septic arthritis of the acromioclavicular joint. J Emerg Med 29(4):425–427
Hernigou P, Daltro G, Flouzat-Lachaniette CH, Roussignol X, Poignard A (2010) Septic arthritis in adults with sickle cell disease often is associated with osteomyelitis or osteonecrosis. Clin Orthop Relat Res 468(6):1676–1681
Jerosch J, Muller T, Sons HU, Castro WH (1990) Correlation of the degeneration of the AC joint (acromioclavicular) and rupture of the rotator cuff. Z Orthop Ihre Grenzgeb 128(6):642–647
Kharrazi FD, Busfield BT, Khorshad DS (2007) Acromioclavicular joint reoperation after arthroscopic subacromial decompression with and without concomitant acromioclavicular surgery. Arthroscopy 23(8):804–808
Kim J, Chung J, Ok H (2011) Asymptomatic acromioclavicular joint arthritis in arthroscopic rotator cuff tendon repair: a prospective randomized comparison study. Arch Orthop Trauma Surg 131(3):363–369
Lenz R, Kreuz PC, Tischer T (2014) Arthroscopic resection of the acromioclavicular joint. Oper Orthop Traumatol 26(3):245–253
Lenz R, Kieb M, Diehl P, Grim C, Vogt S, Tischer T (2016) Muscle, tendon and joint injections: what is the evidence? Orthopade 45(5):459–468
Mall NA, Foley E, Chalmers PN, Cole BJ, Romeo AA, Bach BR Jr (2013) Degenerative joint disease of the acromioclavicular joint: a review. Am J Sports Med 41(11):2684–2692
Mazzocca AD, Arciero RA, Bicos J (2007) Evaluation and treatment of acromioclavicular joint injuries. Am J Sports Med 35(2):316–329
Mumford EB (1941) Acromioclavicular dislocation: a new operative treatment. J Bone Joint Surg Am 23:799–802
Nevalainen MT, Ciccotti MG, Morrison WB, Zoga AC, Roedl JB (2016) Distal clavicular osteolysis in adults: association with bench pressing intensity. Skelet Radiol 45(11):1473–1479
Neviaser TJ, Neviaser RJ, Neviaser JS, Neviaser JS (1982) The four-in-one arthroplasty for the painful arc syndrome. Clin Orthop Relat Res (163):107–112
Nourissat G, Henon A, Debet-Mejean A, Clement P, Dumontier C, Sautet A, Doursounian L (2007) Three-dimensional computed tomographic scan of the external third of the clavicle. Arthroscopy 23(1):29–33
O’Brien SJ, Pagnani MJ, Fealy S, McGlynn SR, Wilson JB (1998) The active compression test: a new and effective test for diagnosing labral tears and acromioclavicular joint abnormality. Am J Sports Med 26(5):610–613
Pensak M, Grumet RC, Slabaugh MA, Bach BR Jr (2010) Open versus arthroscopic distal clavicle resection. Arthroscopy 26(5):697–704
Rios CG, Arciero RA, Mazzocca AD (2007) Anatomy of the clavicle and coracoid process for reconstruction of the coracoclavicular ligaments. Am J Sports Med 35(5):811–817
Sahara W, Sugamoto K, Murai M, Tanaka H, Yoshikawa H (2006) 3D kinematic analysis of the acromioclavicular joint during arm abduction using vertically open MRI. J Orthop Res 24(9):1823–1831
Singh B, Gulihar A, Bilagi P, Goyal A, Goyal P, Bawale R, Pillai D (2018) Magnetic resonance imaging scans are not a reliable tool for predicting symptomatic acromioclavicular arthritis. Should Elb 10(4):250–254
Stine IA, Vangsness CT Jr (2009) Analysis of the capsule and ligament insertions about the acromioclavicular joint: a cadaveric study. Arthroscopy 25(9):968–974
Strauss EJ, Barker JU, McGill K, Verma NN (2010) The evaluation and management of failed distal clavicle excision. Sports Med Arthrosc Rev 18(3):213–219
Tauber M (2016) Diseases of the acromioclavicular joint. Orthopade 45(6):555–568
Tauber M, Koller H, Hitzl W, Resch H (2010) Dynamic radiologic evaluation of horizontal instability in acute acromioclavicular joint dislocations. Am J Sports Med 38(6):1188–1195
Veen EJD, Donders CM, Westerbeek RE, Derks RPH, Landman EBM, Koorevaar CT (2018) Predictive findings on magnetic resonance imaging in patients with symptomatic acromioclavicular osteoarthritis. J Shoulder Elb Surg 27(8):e252–e258
Walton J, Mahajan S, Paxinos A, Marshall J, Bryant C, Shnier R, Quinn R, Murrell GA (2004) Diagnostic values of tests for acromioclavicular joint pain. J Bone Joint Surg Am 86-A(4):807–812
Wang J, Ma JX, Zhu SW, Jia HB, Ma XL (2018) Does distal clavicle resection decrease pain or improve shoulder function in patients with acromioclavicular joint arthritis and rotator cuff tears? A meta-analysis. Clin Orthop Relat Res 476(12):2402–2414
Wellmann M, Smith T (2012) Epidemiology, anatomy, biomechanics and imaging of acromioclavicular joint injuries. Unfallchirurg 115(10):867–871
Zanca P (1971) Shoulder pain: involvement of the acromioclavicular joint. (Analysis of 1,000 cases). Am J Roentgenol Radium Therapy, Nucl Med 112(3):493–506
Author information
Authors and Affiliations
Corresponding author
Section Editor information
Rights and permissions
Copyright information
© 2019 Springer-Verlag GmbH Deutschland, ein Teil von Springer Nature
About this entry
Cite this entry
Lenz, R. (2019). Arthrose des Acromioclaviculargelenks. In: Orthopädie und Unfallchirurgie. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-54673-0_36-1
Download citation
DOI: https://doi.org/10.1007/978-3-642-54673-0_36-1
Received:
Accepted:
Published:
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-54673-0
Online ISBN: 978-3-642-54673-0
eBook Packages: Springer Referenz Medizin