Purpose: To perform a review of the literature focusing on rehabilitation protocols in patients with acromioclavicular (AC) joint injuries treated operatively and nonoperatively and to provide an updated rehabilitation treatment algorithm.
Methods: Studies were identified by searching the MEDLINE database from 01/1995 to 09/2020. Included studies contained detailed rehabilitation protocols with physiologic rationale for AC joint injuries. Biomechanical studies, technique articles, radiographic studies, systematic reviews, case studies, editorials, and studies that compared nonoperative versus operative treatment without focus on rehabilitation were excluded. Following identification of the literature, an updated treatment algorithm was created.
Results: The search strategy yielded 1742 studies, of which 1654 studies were excluded based on title, 60 on the abstract, and 25 on the full manuscript. One study was manually identified using article reference lists, yielding four publications presenting detailed rehabilitation protocols based on physiologic rationale. No randomized controlled trials or comparative studies were identified or cited as a basis for these rehabilitation protocols.
Conclusion: Few detailed rehabilitation protocols in patients with AC joint injuries have been published. These protocols are limited by their standardization, arbitrary timelines, and provide minimal assessment of individual patient characteristics. The quality of patient care can be improved with more practical guidelines that are goal-oriented and allow for critical thinking among clinicians to address individual patient needs. Three common barriers preventing successful rehabilitation were identified and addressed: Pain, Apprehension, and (anterior chest wall) Stiffness to regain Scapular control, effectively termed “PASS” for AC joint rehabilitation.
Clinical Relevance: Rehabilitation protocols for AC joint injuries should be less formulaic and instead allow for critical thinking and effective communication among clinicians and therapists to address individual patient needs.

Keywords: acromioclavicular joint, AC joint, rehabilitation, physical therapy

中文翻译：

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肩锁关节损伤：有效康复

目的：回顾文献，重点关注手术和非手术治疗的肩锁关节 (AC) 关节损伤患者的康复方案，并提供更新的康复治疗流程。
方法：通过搜索 MEDLINE 数据库从 01/1995 到 09/2020 确定研究。纳入的研究包含详细的康复方案以及 AC 关节损伤的生理学原理。生物力学研究、技术文章、放射学研究、系统评价、案例研究、社论和比较非手术治疗与手术治疗但不关注康复的研究被排除在外。在识别文献后，创建了更新的治疗算法。
结果：搜索策略产生了 1742 项研究，其中 1654 项研究基于标题被排除，60 项来自摘要，25 项来自完整手稿。一项研究是使用文章参考列表手动确定的，产生了四份出版物，介绍了基于生理学原理的详细康复方案。没有发现或引用随机对照试验或比较研究作为这些康复方案的基础。
结论：很少有针对 AC 关节损伤患者的详细康复方案发表。这些协议受到其标准化、任意时间线的限制，并且对个体患者特征的评估最少。更实用的指南可以提高患者护理的质量，这些指南以目标为导向，并允许临床医生进行批判性思考，以解决个别患者的需求。确定并解决了三个阻碍成功康复的常见障碍：疼痛、恐惧和（前胸壁）恢复肩胛骨控制的僵硬，有效地称为 AC 关节康复的“PASS”。
临床相关性：AC 关节损伤的康复方案应该不那么公式化，而是允许临床医生和治疗师之间进行批判性思维和有效沟通，以满足个体患者的需求。

Keywords:肩锁关节, AC关节, 康复, 物理治疗