Coracoclavicular ligament reconstruction with the autogenous anterior half of the peroneus longus tendon for acromioclavicular joint dislocations

Abstract

Objective To report the clinical and radiological outcomes of coracoclavicular ligament reconstruction with an autogenous anterior half of the peroneus longus tendon (AHPLT) for acromioclavicular (AC) joint dislocations. Methods Between June 2013 and April 2015, a total of 24 patients with AC joint dislocation of Rockwood types Ⅲ to Ⅴ underwent surgical repair using coracoclavicular ligament reconstruction with an autogenous AHPLT graft. They were 20 men and 4 women, aged from 22 to 68 years (average, 50.7 years). The left side was affected in 15 cases and the right in 9. According to Rockwood classification, there were 5 cases of type Ⅲ, 5 ones of type Ⅳ and 14 ones of type Ⅴ. Twenty of them had acute injury and 4 chronic injury. They were evaluated preoperatively and at 1, 3, 6, and 12 months postoperatively in terms of the Constant score, American Orthopedic Foot and Ankle Society(AOFAS) ankle-hindfoot score,visual analogue scale (VAS) score, and loss of reduction on radiographs. Results Twenty patients completed clinical and radiographic follow-ups at 6 and 12 months postoperatively while the other 4 did not. At postoperative 6 and 12 months, the Constant scores were 81and 96 for the affected side and both 96 for the healthy side, respectively. The Constant score at 6 months for the affected side was significantly lower than that for the healthy side (P 0.05). At postoperative 6 and 12 months, the VAS scores for the affected side were 2 and 0 respectively, significantly lower than the preoperative one (5) (P 0.05). One patient complained of shoulder pain at postoperative 12 months. No surgical site infection or perioperative fracture was observed. Conclusions Coracoclavicular ligament reconstruction with an autogenous AHPLT proves effective for AC joint dislocations. Since it is easy and safe to harvest an autogenous AHPLT and the usable length of AHPLT graft is sufficient for reconstruction, autogenous AHPLT may be a reliable alternative to the present tendon graft sources for coracoclavicular ligament reconstruction. Key words: Shoulder joint; Dislocation; Ligaments, articular