Treatment of AC dislocation by reconstructing CC and AC ligaments with allogenic tendons compared with hook plates

Abstract

BackgroundThe purpose of this study was to compare outcomes between allograft reconstruction and hook plate fixation for acute dislocation of the acromioclavicular joint with a minimum 2-year follow-up.MethodsA retrospective comparative study of patients treated for acute acromioclavicular joint dislocation from February 2010 to December 2014 in our hospital, consisting of 16 patients who were followed-up, was performed.Eight patients were treated for acute AC dislocation and underwent surgical reconstruction as follows: the coracoclavicular and acromioclavicular ligaments were reconstructed with the allogenic tendon. The other eight patients were treated with hook plates to maintain the AC joint reset. At the latest follow-up, radiographic analysis and the Constant and University of California-Los Angeles (UCLA) scores were used to evaluate shoulder function. The satisfaction of the patients in terms of the efficacy and visual analog scale (VAS) data were also recorded.ResultsAfter an average follow-up of 30.3 months (range 24–46 months), no patient had dislocated their joint again at the final follow-up based on X-ray examination. The Constant score was 94.4 for the allogenic tendon group and 93.8 for the hook plate group (P = 0.57). According to the UCLA scale (P = 0.23) or VAS (P = 0.16), we found no significant difference between the two groups. All patients reported that they were very satisfied or satisfied with the outcome of surgery, and no significant difference (P = 0.08) was found between the two groups.ConclusionsThe use of allogenic tendon for reconstruction of the coracoclavicular and acromioclavicular ligaments shows excellent outcomes in terms of the recovery of clinical function or radiographic outcomes for acute AC dislocation. Compared with the hook plate, the hardware did not need to be removed.

The frequency of reduction loss after arthroscopic fixation of acute acromioclavicular dislocations using a double-button device, and its effect on clinical and radiological results

“…Recently, some authors have suggested CC ligament reconstruction by using tendon grafting [23]. However, in another study, 47% reduction loss and 20% complications were seen after CC ligament reconstruction with an autologous tendon graft, which adversely affected the results [11].…”

Chronic acromioclavicular dislocations: multidirectional stabilization without grafting

“…A pad was placed beneath the scapula. A saber cut incision 61 , 72 , 78 was made in line from the coracoid process to the medial AC joint.…”

<p>Optimal Management of Acromioclavicular Dislocation: Current Perspectives</p>

“…This advantage was shown by Wang et al in their clinical comparison of suspensory device fixation with additional tendon allograft compared to hook plating. 46 Additionally, Millett et al 47 described the advantage of suspensory device fixation in relation to its arthroscopically assisted approach, which allows for the detection of concomitant glenohumeral pathologies associated with acute and chronic acromioclavicular joint injuries. 24 Clinical short-term results after suspensory device fixation showed excellent postoperative outcome scores (mean ASES score of 93.8 points) and no further revision surgery, however, complications occurred in 23%.…”