A combined technique for acromioclavicular reconstruction after acute dislocation – technical description and functional outcomes

Abstract

ObjectiveThis study aims to describe the surgical approach to such injuries and to present the clinical and functional outcomes obtained in a cohort of patients.MethodsThis is an observational retrospective study that included 153 patients with acute acromioclavicular joint dislocation, operated between 1999 and 2015. Clinical evaluation included the following outcomes: Constant functional scale, development of complications, time to return to previous work/sport activities, and satisfaction index. The contra-lateral (uninjured) shoulder was used as control in subjective outcomes. Radiological evaluation was performed in order to monitor signs of loss of reduction, degenerative joint changes, and coracoclavicular calcifications.ResultsThe mean age was 29.20 ± 9.53 (16–71), with a large male predominance (91.5%). Follow-up lasted 55.41 ± 24.87 (12–108) months. The mean Constant score attained was 96.45 ± 4.00 (84–100) on operated shoulders and 98.28 ± 1.81 (93–100) on contralateral ones. Almost all patients (98.69%) were satisfied with the surgical results. Worse outcomes were observed in acromioclavicular joint dislocations of increasing grade (from type III to V, but worse for type IV), both concerning the Constant score and return to work or sport. The overall incidence of complications was considered low, with the most prevalent being Kirschner wire failure and isolated coracoclavicular ligament calcifications.ConclusionThe surgical technique described is an excellent option in the treatment of acute acromioclavicular joint dislocations of Rockwood grades III to V. This is corroborated by the excellent clinical and functional outcomes and the low rate of complications.

Biologic and synthetic ligament reconstructions achieve better functional scores compared to osteosynthesis in the treatment of acute acromioclavicular joint dislocation

“…Of these, 191 were excluded based on their abstract and 47 additional studies were excluded based on the full‐text article. One hundred and thirty‐three [1, 2, 4, 5, 7–10, 12–15, 17–23, 25, 29, 30, 32–41, 43–46, 49–52, 54–61, 64–67, 69–73, 75–82, 86–95, 97–99, 102–109, 111, 113, 117, 118, 120, 122–130, 133, 135, 137–139, 143, 144, 146–156, 158, 160–162, …”

“…Loss of reduction was reported on X‐rays in 116 studies [2, 4, 7, 10, 12–15, 17–23, 25, 29, 30, 32–41, 43, 45, 46, 49–52, 54–61, 64–67, 69–73, 75–77, 86–88, 90–92, 94, 95, 97, 98, 102–104, 106–109, 111, 117, 118, 122–130, 133, 135, 137–139, 143, 144, 146–154, 156, 158, 160–162, 165–167, 170–177], computed tomography (CT) was used in one study...…”

“…[1, 2, 7–9, 12, 14, 15, 17, 18, 20, 23, 25, 30, 32, 34, 36, 38, 40, 41, 44–46, 49, 50, 54, 56, 58, 64, 65, 67, 69–72, 75, 76, 78–80, 82, 86, 87, 89, 91, 92, 94, 95, 98, 99, 102–104, 108, 109, 111, 113, 117, 118, 120, 122–124, 126–129, 133, 135, 137, 138, 144, 147–151, 153–156, 158, 160–162, 166, …”

Reconstruction of Coracoclavicular Ligament with Endobutton and Sutures to Stabilize Acromioclavicular Joint: A Retrospective Clinical Study and Finite Element Analysis

“…With the development of the anatomy and biomechanics of acromioclavicular joint, rigid xation has been gradually eliminated due to its high failure rate. Anatomical reconstruction of coracoclavicular ligament has become a popular method recommended by many scholars, including Endobutton mini steel plate, autogenous or allogeneic tendon, and rivet with suture (6). However, the importance of acromioclavicular ligament in maintaining joint stability has been ignored.…”

Functional results of surgical treatment for acromioclavicular joint dislocation using the modified weaver-dunn surgical technique

“…One of the most employed and widespread techniques for surgical treatment is the modified Weaver-Dunn procedure, which involves the transfer of the coracoacromial ligament and its insertion in the acromion to the distal third of the clavicle with the aid of ties. [11][12][13] The objective of the present study was to evaluate the functional results of patients who underwent surgical treatment using the modified Weaver-Dunn technique for the treatment of acromioclavicular dislocation, with the UCLA (University of California, Los Angeles) score system. 14,15 It is understood that this technique will lead to a good functional outcome, returning the same working function prior to injury.…”