Minimally invasive suture anchor – metallic button construct for acute acromioclavicular dislocations: A functional outcome pilot study in military cohort

Abstract

Context: The best technique to achieve the optimum functional outcome in acute acromioclavicular (AC) injuries in young, active patients continues to be a matter of debate. Aims: The aim of this study is to evaluate the functional outcome of a minimally invasive technique for acute AC dislocation in military soldiers. Settings and Design: The study design involves prospective study from 2012 to 2016 at a tertiary care Military Orthopaedic center. Materials and Methods: Patients with an acute Rockwood Type III, IV, and V AC injury were included polytrauma, injury older than 2 weeks or requiring an open reduction, ipsilateral limb, and neurological injuries were excluded from the study. All patients underwent minimally invasive, percutaneous reduction and fixation with a suture anchor–metallic button construct. Patients were followed up at 6, 12, 24 weeks, 1 year, and 2 years postoperatively for radiological and functional assessment (Constant score). Statistical Analysis: Using analytical tests in SPSS software for comparison of coracoclavicular (CC) distance on the injured and healthy sides. Results: There were 25 male soldiers and cadets with a mean age of 24.5 ± 5.5 years. The mean follow-up duration was 37.9 ± 6.26 weeks. Twenty-four (96%) patients achieved pain-free, overhead shoulder abduction at 24 weeks follow-up with a mean constant score of 88.4 ± 7.43. The mean constant score at the last follow-up was 94.5 ± 5.67. Twenty-three (92%) patients had a well reduced AC joint; mean CC distance on the affected side was 9.1 ± 1.2 mm, comparable to mean distance of 8.9 ± 1.4 mm on the healthy side without any evidence of sclerosis or osteolysis till the last follow-up, while one patient had a recurrent dislocation. Conclusions: Suture anchor metallic button construct is a simple, surgeon friendly technique for young, high-demand patients to restore AC biomechanics in a minimally invasive manner.