ACG osteoarthritis can be divided into different categories:

1. Primary ACG osteoarthritis: Age-related wear of the cartilage without any identifiable pre-existing condition.
2. Secondary ACG osteoarthritis: Result of injuries, such as an acromioclavicular joint dislocation or chronic overuse.
3. Post-traumatic ACG osteoarthritis: Develops after fractures or surgical interventions on the joint.

The main causes of ACG osteoarthritis can be divided into the following categories:

Mechanical overload:

• Regular and repeated overhead movements, as in sports or occupational activities, lead to excessive strain on the joint.
• Chronic stress from heavy lifting or intensive shoulder movements.

Injuries:

• Traumatic events, such as a fall or a direct blow to the shoulder joint.
• Instability after an acromioclavicular joint dislocation or improper healing after injuries.

Degenerative processes:

• Age-related wear of the joint cartilage, leading to a reduction in glide ability and load-bearing capacity.
• Chronic microtraumas that accelerate cartilage degradation.

The symptoms vary depending on the severity of the condition, but often include:

• Localized pain: Pain is concentrated on the acromioclavicular joint, intensified by movements such as lifting the arm overhead.
• Movement restrictions: Limitation in daily activities such as dressing or lifting objects.
• Tenderness: Pain when touching or applying light pressure to the joint.
• Swelling and deformity: Visible changes or swelling in the area of the joint.
• Grinding and rubbing: Noises when moving the joint, caused by the abrasion of cartilage and bone.

The diagnosis is made through a combination of medical history, physical examination, and imaging techniques:

- Medical history: The doctor asks about symptoms, occupational or sports-related stress, and previous injuries.

- Physical examination:

- Palpation of the joint for tenderness.

- Functional tests such as the cross-body test to reproduce pain.

- Imaging techniques:

- X-ray: Shows joint space narrowing, osteophytes, or other degenerative changes.

- MRI: Provides detailed information about cartilage damage and inflammation.

- Ultrasound: Detects inflammatory processes and fluid accumulation.

Conservative Therapy

In most cases, ACG osteoarthritis can be treated without surgery:

• Rest and Load Reduction: Avoidance of strenuous activities to reduce inflammation and pain.

• Physiotherapy:

  • Exercises for mobilization and stabilization of the shoulder joint.
  • Strengthening of the surrounding muscles to relieve the joint.

• Medication Therapy:

  • NSAIDs (non-steroidal anti-inflammatory drugs) for pain relief and anti-inflammation.
  • Injections: Cortisone or hyaluronic acid for short-term relief.

Surgical Therapy

In cases of severe discomfort or unsuccessful conservative treatment, surgery may be necessary:

• Arthroscopic Resection: Removal of the degenerated joint part to alleviate pain.

• Minimally Invasive Techniques: Modern procedures allow for faster healing and lower risks.

• Joint Reconstruction: Replacement with artificial material in cases of severe damage.

To prevent ACG osteoarthritis, the following measures are recommended:

• Load management: Regular breaks during strenuous activities.
• Appropriate ergonomics: Adjusting workstations and aids to avoid overloading.
• Strengthening the shoulder muscles: Improving stability and relieving the joint.
• Early treatment of injuries: Avoiding chronic damage through adequate care.