Artikel
Long-Term Follow-up in a Single-Bundle Arthroscopic Acromioclavicular Joint Reconstruction After Rockwood III to VI Dislocation
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Autoren
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Antoon Van Raebroeckx
- Vitaz, Puurs-Sint-Amands, Belgium
| Veröffentlicht: | 25. Oktober 2022 |
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Gliederung
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Aim: This retrospective study presents the clinical and radiographic results of a single-bundle arthroscopic acromioclavicular joint reconstruction in 45 patients with a mean follow-up of 4.8 years.
Background: Many surgical methods exist to treat ACJ luxation, but no gold standard has been established so far. Addressing horizontal and rotational stability has gained attention in the past decade, using multiple-bundle reconstructions. However, this has been associated with the risk of clavicle fractures (6) and optimal biomechanical tunnel positioning is still an important questioned topic (4, 6, 7). In our centre, a full arthroscopic technique with a single synthetic construct has been used to treat acute and chronic ACJ luxation.
Methods: Patients with a Rockwood grade III or higher treated operatively were included. Clinical results were based on satisfaction, pain and functional scores. These outcome scores were compared to coracoclavicular distance measurement on X-ray. Secondly, clinical outcome scores were compared between patients who had surgery in the first 6 weeks after trauma and patients treated after 6 weeks.
Results: Overall, X-ray showed a good reduction in 71.1% of the patients (less than 50% loss of reduction). These patients showed better clinical results than patients with radiographical failure in terms of satisfaction (p = .001), Constant (p = .001), DASH (p =.031) and SPADI (p = .005) scores. In total, 78% of the patient had surgery in the first 6 weeks after trauma. When treated later (mean time to surgery of 8.8 months), patients showed worse results for satisfaction (p = .003) and DASH score (p = .006), suggesting that treatment of chronic cases might warrant additional fixation techniques
Conclusion: As a conclusion, these results showed that, in the acute approach, single-bundle arthroscopic coracoclavicular fixation is a good treatment in acromioclavicular joint dislocation Rockwood grade III or higher. Provided good reduction, patients showed good clinical results at follow-up after 4.8 years.
