Rehabilitación de la cirugía de la articulación acromioclavicular

Abstract

There is not enough evidence to recommend a particular surgical technique for the surgical treatment of acromioclavicular joint dislocations. There is a lack of studies in the literature evaluating rehabilitation programs to treat post-operative acromioclavicular dislocations, although enough data can be found to make some recommendations.

Length of immobilisation depends on tissue healing time frames of the surgical procedure. In general, the joint must be protected for the first 3 to 6 weeks to allow the biological healing process. Active range of motion is initiated at 6 to 8 weeks, with resistance strength activities withheld for 12 weeks.

When the brace is removed, the patient can start with passive assisted range of motion exercises. Caution must be used with internal rotation behind the back, cross-body adduction, and end range forward elevation. After 6 weeks, active exercises can be added with support of the limb on a table or wall.

Scapular dyskinesia has been related to acromioclavicular dislocation. For this purpose, closed chain scapular exercises with the hand fixed to a wall or table are recommended in early stages (6 to 8 weeks after surgery). Isotonic strength exercise can be started after 12 weeks, with tubing or cable resistance. Open chain exercises, like Blackburn's, produce stress in the acromioclavicular joint and should be left for an advanced phase of treatment.