Clinical outcome of delayed surgical treatment of grade III acromioclavicular joint dislocation with and without acromioclavicular capsule reconstruction

Abstract

Background: Surgical management of grade III acromioclavicular joint dislocation should be considered in patients who have significant deformity, tenting of the skin, or persistent pain despite nonsurgical management, or in patients who have a higher functional demand. Coracoclavicular ligament reconstruction alone may not be sufficient to prevent anteroposterior translation at the acromioclavicular joint despite preventing superior translation. Reconstruction of the acromioclavicular capsule may be necessary for additional joint stability. The aim of this study was to evaluate the necessity of the capsular reconstruction in the treatment of acromioclavicular dislocation. Methods: This is a retrospective comparative study between two groups. The first group, 14 patients, had anatomical coracoclavicular ligament reconstruction without capsular reconstruction. The second group, 19 patients, had capsular reconstruction in addition to acromioclavicular ligament reconstruction. Results: Pain, American Shoulder and Elbow Surgery, and Constant Shoulder scores were better in the second group. No cases of failure were reported in any group. Loss of reduction occurred in seven patients in first group (50%). Conclusions: Reconstruction of the acromioclavicular capsule in surgical treatment of grade III acromioclavicular joint dislocation may play an important role against loss of reduction.