Coracoclavicular Space Widening on Radiographs After Arthroscopic Stabilization With Suspensory Fixation Does Not Affect Athletic Performance

Abstract

Purpose: To evaluate the effect of the coracoclavicular distance widening in athletes after arthroscopic acromioclavicular (AC) stabilization using a suspensory button fixation device in terms of function, athletic performance, or isokinetic assessment. Methods: Sixty-eight athletes with a minimum 6-month follow-up after AC stabilization using suspensory button fixation were allocated in 2 groups, the widening group and non-widening group, according to the measured coracoclavicular distance after 6 months from the operation. The assessment was done every 6 months by Subjective Patient Outcome for Return to Sports (SPORTS) score, Athletic Shoulder Outcome Scoring System (ASOSS), Disabilities of the Arm, Shoulder, and Hand (DASH) score, ConstanteMurley score (CMS), and the coracoclavicular distance. Isokinetic testing was performed at 24 months postoperatively to evaluate shoulder abduction and external rotation strength. Results: No statistically significant differences were found between the 2 groups in terms of the DASH, ASOSS, SPORTS, and the CMS, in addition to the isokinetic testing (P > .05). A statistically significant improvement in both groups over the follow-up stage was identified in the DASH, ASOSS, SPORTS, and the CMS (P < .05). Conclusions: Coracoclavicular distance widening following arthroscopic suspensory button fixation for AC joint dislocation did not affect function, athletic performance, or isokinetic evaluation in athletes. Level of Evidence: III; nonrandomized, comparative trial.A cromioclavicular (AC) joint dislocations are a common injury that account for almost 50% of sports-related shoulder injuries. [1][2][3] The Rockwood classification is the most commonly used classification system. Conservative management is widely used for type I and II dislocations, whereas surgical treatment the intervention of choice for type IV to VI dislocations. 1,[4][5][6] Many surgical options have been reported in the literature, all of which aim for full recovery with the return to the preinjury level of activity and sport participation. [6][7][8] The suspensory button fixation was reported initially for the fixation of syndesmotic ankle injuries. The use of these devices in the treatment of AC dislocations has been described in open and arthroscopic techniques. 7,[9][10][11] The loss of AC joint reduction, as evident by coracoclavicular (CC) distance widening, is commonly reported after AC stabilization using suspensory button fixation devices. The effect of such findings on the athletic performance of patients is not yet fully understood. 7,9,[11][12][13][14][15] The purpose of this study is to evaluate the effect of CC distance widening in athletes after arthroscopic AC joint stabilization using a suspensory bottom fixation device in terms of function, athletic performance, and/or isokinetic assessment. We hypothesized that the CC distance rewidening after AC joint stabilization using a suspensory button fixation might affect the function and athletic performance of the shoulder joint. Methods