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Anatomical observations on the acromioclavicular joint and supporting ligaments

Division of Physical Therapy, School of Community and Allied Health

Richard J. Nasca

Division of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, Alabama

Brian S. Shelley

Division of Physical Therapy, School of Community and Allied Health

An anatomical study of the acromioclavicular (AC) joint and its supporting ligaments was performed using both macroscopic and microscopic methods. The project used 63 cadaver shoulders of unknown ages. Fifty- three joints were used for macroscopic and 10 for microscopic study. The data consisted of 1) micrometer measurements of the dimensions of the extrinsic and intrinsic ligaments of the AC joint; 2) measurement and description of the intraarticular meniscus and the su perior and inferior capsular ligaments of the AC joint; and 3) the anatomical course and relationship of the coracoacromial (CA) ligament to the supporting liga ments of the AC joint and a description of its insertion on the acromion process.

The following observations were made: The cor acoclavicular ligament, especially the trapezoid liga ment, provides significant soft tissue restraints to up ward displacement of the clavicle. A complete AC joint disc was found in only one, meniscoid discs in 25, remnants of discs in 16, and no discs in 11 of the 53 joints studied macroscopically. (No age correlation was made since the ages of the cadavers were unknown.) The CA ligament interconnects with the inferior capsular ligament of the AC joint as well as with the coracoclavic ular and coracohumeral ligaments. It also has a broad area of insertion on the inferior acromial surface.

The CA ligament appears to function as a buffer between the acromion and the rotator cuff, and to provide support for the AC joint. Transection of the CA ligament may result in loss of this buffering function.

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