Acromioclavicular joint injuries: multicenter expert consensus study using the Delphi method

Abstract

Background: Acromioclavicular (AC) joint injuries pose significant challenges in clinical management, necessitating consensus guidelines for optimal treatment. There is a lack of consensus in several areas, including imaging protocols, surgical techniques, and rehabilitation timelines. This study aims to develop a consensus regarding the diagnosis, treatment, and rehabilitation of AC joint separations.

Methods: Using the Delphi method to gather expert opinions, 18 fellowship-trained surgeons from the American Shoulder and Elbow Surgeons participated in 3 survey rounds, achieving a 100% response rate over each round.

Results: A total of 76 consensus statements were identified in 6 areas: history, physical examination, radiology, treatment, surgical technique, and rehabilitation. Consensus was reached on some of the fundamental principles of AC separation management, such as the importance of a comprehensive history and physical examination, multiple radiographic views of the joint, indications for surgery, and the usefulness of allograft tendon augmentation for repair of the joint when surgery is indicated.

Conclusion: The Delphi method proved effective in gathering diverse perspectives and quantifying consensus among experts, offering important insights into the management of AC joint injuries. Continued research efforts are warranted to address areas of controversy and establish improved guidelines for the diagnosis and treatment of these injuries.

Keywords: Delphi; Shoulder; acromioclavicular joint; consensus; diagnosis; treatment.