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- Title
Anatomic coracoclavicular ligament reconstruction (ACCR) using free tendon allograft is effective for chronic acromioclavicular joint injuries at mid-term follow-up.
- Authors
Cerciello, Simone; Berthold, Daniel P.; Uyeki, Colin; Kia, Cameron; Cote, Mark P.; Imhoff, Andreas B.; Beitzel, Knut; Corona, Katia; Mazzocca, Augustus D.; Muench, Lukas N.
- Abstract
<bold>Purpose: </bold>To evaluate the clinical and radiographic outcomes of patients undergoing anatomic coracoclavicular ligament reconstruction (ACCR) using free tendon allografts for the treatment of chronic acromioclavicular joint (ACJ) injuries with a minimum 1-year follow-up.<bold>Methods: </bold>Patients who underwent ACCR for chronic ACJ injuries between 2003 and 2017 were analyzed. Clinical outcome measures included American Shoulder and Elbow Surgeons (ASES), Constant-Murley (CM), Simple Shoulder Test (SST), and Single Assessment Numerical Evaluation (SANE) scores. Radiographic loss of reduction during follow-up was evaluated by calculating the difference (mm) in the coracoclavicular distance (CCD) of the involved side immediately postoperatively and at terminal follow-up.<bold>Results: </bold>Forty-two patients (mean age: 42.7 ± 12.8 years) were included in the study with an average follow-up of 3.8 ± 3.1 years (range: 1.1-11.5 years). Patients achieved significant improvement in ASES (50.2 ± 20.1 pre to 85.2 ± 16.3 post), CM (60.2 ± 18.5 pre to 88.2 ± 9.1 post), SST (6.1 ± 3.2 pre to 9.5 ± 3.7 post), and SANE (24.0 ± 25.7 pre to 89.0 ± 12.7 post) scores (P < 0.001, respectively). There were no significant differences in functional improvement when comparing type III and V injuries (n.s.). Mean increase in CCD of the involved side from immediately postoperative to final radiographic follow-up was 4.1 ± 3.9 mm, with no significant correlation to clinical outcomes scores. Complications occurred in 33.3% of cases, with postoperative heterotopic ossification being most frequent (14.3%).<bold>Conclusion: </bold>Patients undergoing ACCR using free tendon allografts for chronic ACJ injuries achieved significant improvement in shoulder function at a mean follow-up of 3.8 years. No correlation was observed between the amount of loss of reduction and clinical outcome scores. Free tendon allografts may be a reliable alternative to autografts in the treatment of chronic ACJ dislocations.<bold>Level Of Evidence: </bold>IV.
- Subjects
ACROMIOCLAVICULAR joint; SHOULDER surgery; TENDON surgery; HOMOGRAFTS; SHOULDER injury treatment; HEALTH outcome assessment; CLAVICLE surgery; TENDON transplantation; ARTICULAR ligaments; PLASTIC surgery; SURGICAL complications; RADIOGRAPHY; TREATMENT effectiveness; AUTOGRAFTS; SHOULDER dislocations; LONGITUDINAL method
- Publication
Knee Surgery, Sports Traumatology, Arthroscopy, 2021, Vol 29, Issue 7, p2096
- ISSN
0942-2056
- Publication type
journal article
- DOI
10.1007/s00167-020-06123-0