Arthroscopically-assisted treatment of acute and chronic dislocations of the acromioclavicular joint : Aprospective clinical trial

Abstract

Injuries of the acromioclavicular joint (ACJ) are frequent and often occur during sports. While arthroscopically-assisted stabilization of acute injuries of the ACJ is awell-established procedure, there is not much data available for arthroscopically-assisted stabilization of chronic injuries of the ACJ. This study assesses clinical and radiological results of arthroscopically-assisted stabilization of acute and chronic injuries of the ACJ. Thirty-six patients with acute and chronic injuries of the ACJ were assessed in aprospective clinical trial. Twenty-five patients with acute injuries (groupA) and eleven patients with chronic injuries (groupB) were included in this study. Patients of groupA were operated using two suture-button systems, while patients of groupB received one suture-button system and an autologous gracilis tendon graft. In groupA, the mean preoperative Constant score rated 38, and the ASES score rated 34. At follow-up the Constant score(92) and the ASES score(89) had improved. Panorama views revealed an increased coracoclavicular distance of the affected shoulder (15.8 mm) in comparison to the contralateral shoulder (10.9 mm). In groupB, the preoperative Constant score measured 57. It improved to 72points at follow-up. The ASES score improved from 39 to 72points in the same period. Panorama views revealed an increased coracoclavicular distance of the affected shoulder (18.9 mm) in comparison to the contralateral shoulder (12.4 mm). Stabilization of acute injuries of the ACJ with two suture-button systems is related to very good shoulder function after one year. The native coracoclavicular distance cannot be restored with this procedure. Stabilization of chronic injuries of the ACJ with asuture-button system and an autologous gracilis tendon graft is related to improved shoulder function after one year. However, shoulder function cannot be fully restored with the stabilization technique presented.