Comparative study of arthroscopic coracoacromial ligament augmentation and clavicular hook plate for treatment of acromioclavicular joint dislocation

Abstract

Objective To compare the outcomes of arthroscopic coracoacromial ligament augmentation and clavicular hook plating in treatment of acromioclavicular joint dislocation. Methods From March 2008 to March 2012, 47 patients with acute closed type Ⅲ-Ⅴ acromioclavicular joint dislocations underwent an arthroscopic repair with coracoacromial ligament augmentation and suture (ligament augmentation group, 23 patients) and with AO clavicular hook plate (hook plate group, 24 cases). Mean age of the patients (32 males and 15 females) was 34.8 years (range, 17-45 years). There were 32 left and 15 right injuries. Postoperative outcome was assessed through radiographic examination, American Shoulder and Elbow Surgeon (ASES) score and Karlsson scoring method. Results Mean period of follow-up was 18 months (range, 12-24 months). In ligament augmentation group ASES score improved from (28.7±7.3)points preoperatively to (96.3±6.9)points postoperatively (t=51.34, P<0.05). In hook plate group ASES score improved from (29.3±7.6)points preoperatively to (83.6±8.5)points postoperatively (t=43.78, P<0.05). Postoperative radiographic examination showed well joint reduction of all patients. Good and excellent results with the Karlsson score accounted for 96% (22/23) in ligament augmentation group and 71% (17/24) in hook plate group (χ2=9.05, P<0.05). Conclusions Efficacy of coracoacromial ligament augmentation and suture for the treatment of acromioclavicular joint dislocation is better than clavicular hook plate. Coracoacromial ligament augmentation and suture are associated with lower incidence of shoulder pain and shoulder activity limitation, shorter recovery time, fewer complications and early activities. Key words: Shoulder dislocation; Arthroscopy; Coracoacromial ligament