Endoscopically assisted reconstruction of acute acromioclavicular joint dislocation using a synthetic ligament. Outcomes at 12 months

Doi : 10.1016/j.otsr.2010.10.004

G. Cohen ^a ^b , P. Boyer ^c, N. Pujol ^a ^b, B. Hamida Ferjani ^c, P. Massin ^c, P. Hardy ^a ^b

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Summary

Objectives

The treatment for acute acromioclavicular (AC) joint dislocation remains controversial because of the elevated level of complications and related morbidity. The objective of this study was to evaluate clinical outcomes, radiographic results, and the complications after arthroscopic stabilization of acute stages III or IV (Rockwood classification) acromioclavicular dislocations.

Material and methods

Sixteen patients (15 males and one female) found to have Rockwood stage III or IV AC joint dislocation were operated. All the patients were stabilized arthroscopically with a synthetic ligament placed between the clavicle and the coracoid. The application of the synthetic ligament reduced the dislocation and stabilized the AC joint, allowing healing of the coracoacromial ligament. Results were assessed clinically (Constant score) and radiographically before and a mean 12 months after the treatment.

Results

Despite the excellent clinical results at the last follow-up both in terms of the Constant score (mean, 91 points; range, 60–100) and patient satisfaction, two patients required revision surgery while some had pain over the clavicular button. The X-rays showed three cases of partial loss of reduction due to distal migration of the flip button.

Discussion

Arthroscopically assisted treatment of acute AC joint dislocation is advantageous because it provides good clinical results and few complications. The rate of recurrence and the postoperative loss of reduction requires better definition of the indications and improvement of the surgical implants and technique.