How long should arthroscopic clavicular resection be in acromioclavicular arthropathy? A radiological-clinical study (with computed tomography) of 18 cases at a mean 4 years’ follow-up - 03/04/14

Doi : 10.1016/j.otsr.2014.03.011

W. Kim ^a, A. Deniel ^b, M. Ropars ^a, R. Guillin ^b, A. Fournier ^a, H. Thomazeau ^a,^⁎
^a Service de chirurgie orthopédique et réparatrice, CHU Rennes, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex 09, France
^b Département de radiologie, CHU Rennes, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex 09, France

^⁎Corresponding author. Service de chirurgie orthopédique et traumatologique, CHU de Rennes, 2, rue Henri-le-Guilloux, 35033 Rennes cedex 09, France. Tel.: +33 (2) 2 99 28 97 82.

conectar o crear una cuenta

Bienvenido a EM-consulte, la referencia de los profesionales de la salud.
Artículo gratuito.

Conéctese para beneficiarse!

En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Thursday 03 April 2014
This article has been published in an issue click here to access

Abstract

Introduction

Endoscopic clavicular resection is a common procedure, but few studies have analyzed predictive factors for outcome.

Hypotheses

1) Computed tomography (CT) of clavicular resection is reproductible; 2) Functional outcome correlates with resection length; 3) Other factors also influence outcome.

Material and methods

Patients operated on between 2005 and 2010 were called back to establish functional scores (Constant, Simple Shoulder Test [SST], satisfaction) and undergo low-dose bilateral comparative computed tomography (CT) centered on the acromioclavicular joints. The assessment criteria were resection edge parallelism and resection length, measured using OsiriX^® software. Radiological and clinical data were correlated.

Results

18 out of 21 patients (85%: 3 female, 15 male) were assessed. Mean age at surgery was 49 years (range, 40–62 yrs); mean follow-up was 4.2 years (1.6–7.2 yrs). Mean Constant score rose from 57.7 (25–85) to 70.2 (30–96); mean postoperative SST was 9.3 (3–12). 11 patients had very good and 4 poor results. CT resection length was reproducible, with intraclass, intra- and interobserver correlation coefficients >95%. There was no significant correlation between articular resection length on CT and functional scores (P=0.2). Functional scores were negatively influenced by an occupational pathologic context (P<0.01) and by associated tendinopathy.

Discussion and conclusion

Low-dose CT enabled reproducible analysis of clavicular resection. The hypothesized correlation between resection length and functional result was not confirmed. Work accidents and occupational disease emerged as risk factors.