Acromioclavicular Joint

• Plane synovial joint with 3°freedom

• Attaches the scapula to the clavicle
• Has a joint capsule, two major ligaments
and a joint disk
• Helps to maintain relation between the clavicle
and the scapula in the early stages of elevation of
the upper limb
• Allows additional ROM on the thorax in the latter
stages of elevation
Articulating Surfaces:
• Lateral end of clavicle articulates with a
small facet on the acromion process of the
scapula
• Articular surfaces are incongruent
• They may be flat, reciprocally concave-
convex or reversed
Acromioclavicular disk: 
• Variable in size
• At two years the disk is a fibrocartilagenous
union
• Overtime a meniscoid fibro cartilage
develops which functions as disk
Capsule and ligaments:
• Capsule is weak & reinforced by AC
(acromioclavicular) and CC
(coracoclavicular) ligaments
• AC ligament has a superior and inferior part
• Superior part assists the capsule and helps
in controlling horizontal joint stability
• CC ligament is subdivided into a lateral
portion called the trapezoid ligament and a
medial portion called the conoid ligament
• Provides much of the joint stability and
firmly unites clavicle and scapula
• CC ligament helps in the following:
b. Prevents upward rotation of the scapula –
if scapula were to upwardly rotate at the
AC joint the coracoid process would drop
away from the clavicle,this cannot happen
as long as CC ligaments are intact
a. Transfers the medially directed forces of the
scapula on to the clavicle – potentially large
external forces which push the humerus into the
glenoid fossa and medially directed muscles of
the scapula would displace the scapula medially
on the thorax
 Small AC joint and its weak capsule and
ligaments will not be able to resist such forces so
the clavicle would override the acromion and
joint would dislocate
 This is prevented by the tension in the CC
ligament which transfers these forces on to the
SC joint
d. Helps in longitudinal rotation of the clavicle
which is necessary to complete full ROM for the
upper extremity
Acromioclavicular Motions:
• Joint affords limited motion
• 2 primary motions occur at AC joint
d) Medial & Lateral Rotation of
scapula
• Occur around a vertical axis
• Medial and lateral rotation bring the glenoid
fossa medially and laterally respectively
• These motions must occur to maintain the
contact of the scapula with the horizontal
curvature of the thorax as the scapula slides
around the thorax in protraction and retraction
• Medial Rotation is a part of scapular protraction
and lateral rotation is a part of retraction
a) Anterior & posterior tipping of
scapula
• Occurs around coronal axis
• Anterior tipping moves the superior
border of the scapula anteriorly and the
inferior angle posteriorly
• Posterior tipping is the opposite of the
above
• These movements occur to maintain the
contact of scapula with contour of rib cage
• Anterior tipping of the scapula occurs in
elevation and posterior tipping occurs in
depression
• Anterior tipping of scapula occurs during
posterior rotation of clavicle
• If there was no AC joint, posterior rotation
of the clavicle would be stopped as the
inferior angle of the scapula would hit the
rib cage
• The AC joint absorbs the rotation of the
clavicle by counter rotating the scapula
(anterior tipping)
• This joint unlike the strong SC joint is
prone to trauma and degenerative change
• This is due to its large and incongruent
surfaces resulting in large forces per unit
area