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Archives of Orthopaedic and Trauma Surgery

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01-04-2020 | Osteoarthrosis | Orthopaedic Surgery

The relationship of the acromion to the distal clavicle in normal and symptomatic degenerated acromioclavicular joints

Authors: Kristof Bulkmans, Ian Peeters, Lieven De Wilde, Alexander Van Tongel

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 4/2020

Abstract

Introduction

Although degenerative osteoarthritis of the acromioclavicular joint is a common finding on technical investigations, not every patient experiences pain or function loss. The difference between symptomatic and asymptomatic patients is currently not elucidated. Therefore, we want to investigate the acromioclavicular relationship in normal, asymptomatic, and symptomatic degenerated ACJ.

Materials and methods

84 normal ACJ, 39 asymptomatic degenerated ACJ, and 30 symptomatic degenerated ACJ were 3D reconstructed. The morphological dimensions and the relationship of the acromion and distal clavicle were measured using computational software. The reproducibility of this technique was evaluated using inter- and intra-observer reliability.

Results

The mean anteroposterior and superoinferior distance of both the clavicle and acromion was significantly larger in asymptomatic and symptomatic degenerative ACJ compared to the normal ACJ (p < 0.001). In symptomatic osteoarthritic ACJ, both the anterior and posterior borders of the acromion were significantly more anterior to the borders of the clavicle than in the normal group and asymptomatic group (p < 0.001). Subsequent ROC curve analysis resulted in a sensitivity of 86.7% and a specificity of 88.6% for anterior subluxation of the ACJ. This technique showed an excellent inter- and intra-observer reliability.

Conclusions

In patients with degenerative ACJ, both the distal clavicle and acromion are enlarged. In asymptomatic patients, the AC relationship is the same as in normal patients, in contrast, in patients with symptomatic degenerative ACJ, the acromion is subluxated anteriorly compared to the clavicle.

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Title: The relationship of the acromion to the distal clavicle in normal and symptomatic degenerated acromioclavicular joints
Authors: Kristof Bulkmans
Ian Peeters
Lieven De Wilde
Alexander Van Tongel
Publication date: 01-04-2020
Publisher: Springer Berlin Heidelberg
Keywords: Osteoarthrosis
Osteoarthrosis
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 4/2020
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-019-03258-9

At a glance: The STEP trials

Springer Medicine

The relationship of the acromion to the distal clavicle in normal and symptomatic degenerated acromioclavicular joints

Abstract

Introduction

Materials and methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Conclusions

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