Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Dec 31;2(2):140-148.
doi: 10.1016/j.xrrt.2021.11.005. eCollection 2022 May.

Criteria for return to play after operative management of acromioclavicular joint separation: a systematic review

Richard J Gawel  1 , Taylor D'Amore  1 , Peters T Otlans  1 , Somnath Rao  1 , Steven B Cohen  1 , Michael G Ciccotti  1
Affiliations
Review

Criteria for return to play after operative management of acromioclavicular joint separation: a systematic review

Richard J Gawel et al. JSES Rev Rep Tech. .

Abstract

Background: Acromioclavicular (AC) joint separation is a common cause of shoulder injury among athletes. High-grade injuries may require operative fixation, and comprehensive return-to-play guidelines have not yet been established. The purpose of this study was to summarize criteria for return to play after operative management of AC joint separation.

Methods: A systematic review of the literature was performed from January 1999 to April 2020 to evaluate clinical evidence regarding criteria for return to play after operative management of isolated AC joint separation.

Results: Sixty-three studies with at least 1 explicitly stated return-to-play criterion were identified out of an initial database search of 1253 published articles. Eight separate categories of return-to-play criteria were identified, the most common of which was time from surgery (95.2%). Return-to-play timelines ranged from 2 to 12 months, the most common timeline being 6 months (37.8%). Only 4 (6.3%) studies used conditional criteria to guide return to play, which included range of motion, strength, clinical stability, radiographic stability, functional assessment, safety assessment, and hardware removal.

Conclusion: Most published studies use only time-based criteria for return to play after surgery for AC joint separation, and only a small number of studies use additional subjective or objective criteria. While this systematic review helps provide a foundation for developing a comprehensive return-to-play checklist, further investigation is needed to establish safe and effective guidelines that will enable athletes to safely return to sport and minimize the recurrence of injury.

Keywords: AC joint; AC joint repair; AC joint separation; Acromioclavicular joint; Return to play criteria; Shoulder.

PubMed Disclaimer

Figures

Figure 1
Figure 1
PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) diagram of search strategy.
Figure 2
Figure 2
Rates of return to play after operative management of AC joint separation reported in the literature.
See this image and copyright information in PMC

References

    1. Abat F., Gich I., Natera L., Besalduch M., Sarasquete J. Clinical factors that affect perceived quality of life in arthroscopic reconstruction for acromioclavicular joint dislocation. Rev Esp Cir Ortopédica Traumatol Engl Ed. 2018;62:121–126. doi: 10.1016/j.recote.2018.01.004. - DOI - PubMed
    1. Barth J., Duparc F., Baverel L., Bahurel J., Toussaint B., Bertiaux S., et al. Prognostic factors to succeed in surgical treatment of chronic acromioclavicular dislocations. Orthop Traumatol Surg Res. 2015;101:S305–S311. doi: 10.1016/j.otsr.2015.09.002. - DOI - PubMed
    1. Beitzel K., Cote M.P., Apostolakos J., Solovyova O., Judson C.H., Ziegler C.G., et al. Current concepts in the treatment of acromioclavicular joint dislocations. Arthrosc J Arthrosc Relat Surg. 2013;29:387–397. doi: 10.1016/j.arthro.2012.11.023. - DOI - PubMed
    1. Beris A., Lykissas M., Kostas-Agnantis I., Vekris M., Mitsionis G., Korompilias A. Management of acute acromioclavicular joint dislocation with a double-button fixation system. Injury. 2013;44:288–292. doi: 10.1016/j.injury.2013.01.002. - DOI - PubMed
    1. Boutsiadis A., Baverel L., Lenoir H., Delsol P., Barth J. Arthroscopic-assisted acromioclavicular and coracoclavicular ligaments reconstruction for chronic acromioclavicular dislocations: surgical technique. Tech Hand Up Extrem Surg. 2016;20:172–178. doi: 10.1097/BTH.0000000000000142. - DOI - PubMed

LinkOut - more resources