Radiographic joint space in normal acromioclavicular joints

The acromioclavicular joint space in standard antero-posterior images of 151 normal subjects was measured. The joint space was significantly wider in men. There was a highly significant reduction of the joint space with age in both men and women and in persons past 60 a joint space of 0.5 mm or less is not pathological. A joint space wider than 7 mm in men and 6 mm in women is abnormal. The measuring technique described is useful in population studies. In individual cases a simple measurement with a ruler serves the same purpose.

Degeneration of the acromioclavicular joint. A morphological study

One hundred and sixty-eight acromioclavicular joint dissections were performed on 85 cadavera, 46 men and 39 women, with an average age of 69, ranging from 18 to 92. The intra-articular discs and the joint cartilages were scrutinized and degenerative changes were graded macroscopically. An age related disintegration of the disc and the joint cartilages was found. After the age of 70 maximum degeneration was very common.

Disruption of the acromioclavicular joint: surgical anatomy and biological reconstruction

The pathological anatomy of acromioclavicular joint disruption is discussed in the light of operative findings. A method of repairing the dislocated joint is described using the coraco-acromial ligament and temporary internal fixation. It has been found to be useful in those patients who present late with pain and symptoms of instability.

The refractory painful arc syndrome

Twenty-three patients with a severe refractory painful arc syndrome have been treated by excision of the outer end of the clavicle and division of the coracoacromial ligament through a deltoid-splitting approach. After a follow-up of more than six months all patients have been relieved of night pain. Six still have slight pain on movement, but the rest are symptom-free.

Post-traumatic osteolysis of the distal clavicle

Five cases of painful bone resorption from the distal clavicle following shoulder trauma are reported to demonstrate that the lesion is generally benign. Surgical excision is curative. The multiplicity of circumstances leading to clavicular osteolysis suggest that the balance between bone accretion and resorption is precarious in this region of the skeleton.