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Anatomic coracoclavicular ligament reconstruction (ACCR) using free tendon allograft is effective for chronic acromioclavicular joint injuries at mid-term follow-up.

Authors
  • Cerciello, Simone1, 2
  • Berthold, Daniel P3, 4
  • Uyeki, Colin3
  • Kia, Cameron3
  • Cote, Mark P3
  • Imhoff, Andreas B4
  • Beitzel, Knut4, 5
  • Corona, Katia6
  • Mazzocca, Augustus D3
  • Muench, Lukas N3, 4
  • 1 Casa di Cura Villa Betania, Rome, Italy. , (Italy)
  • 2 Marrelli Hospital, Crotone, Italy. , (Italy)
  • 3 Department of Orthopaedic Surgery, UConn Health, Farmington, CT, USA.
  • 4 Department of Orthopaedic Sports Medicine, Technical University of Munich, Munich, Germany. , (Germany)
  • 5 Department of Shoulder Surgery, ATOS Clinic, Cologne, Germany. , (Germany)
  • 6 Department of Medicine and Health Sciences Vincenzo Tiberio, University of Molise, Campobasso, Italy. [email protected] , (Italy)
Type
Published Article
Journal
Knee Surgery Sports Traumatology Arthroscopy
Publisher
Springer-Verlag
Publication Date
Jul 01, 2021
Volume
29
Issue
7
Pages
2096–2102
Identifiers
DOI: 10.1007/s00167-020-06123-0
PMID: 32607814
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

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. 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. 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%). 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. IV.

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