Abstract
Purpose: To report clinical and functional outcomes including return to preinjury activity level following arthroscopic-assisted coracoclavicular (CC) ligament reconstruction (AA-CCR) and to determine associations between return to preinjury activity level, radiographic outcomes, and patient-reported outcomes following AA-CCR. Methods: A institutional registry review of all AA-CCR using free tendon grafts from 2007 to 2016 was performed. Clinical assessment included Single Assessment Numeric Evaluation (SANE) score and return to preinjury activity level at final follow-up. Treatment failure was defined as (1) revision acromioclavicular stabilization surgery, (2) unable to return to preinjury activity level, or (3) radiographic loss of reduction (RLOR, >25% CC distance compared with contralateral side). SANE scores, return to activity, and RLOR were compared between patients within each category of treatment failure, by grade of injury, and whether concomitant pathology was treated. Results: There were 88 patients (89.8% male) with mean age of 39.6 years and minimum 2-year clinical follow-up (mean 6.1 years). Most injuries were Rockwood grade V (63.6%). Mean postoperative SANE score was 86.3 ± 17.5. Treatment failure occurred in 17.1%: 8.0% were unable to return to activity, 5.7% had RLOR, and 3.4% underwent revision surgery due to traumatic reinjury. SANE score was lower among patients who were unable to return to activity compared with those with RLOR and compared with nonfailures (P =.0002). There were no differences in revision surgery rates, return to activity, or SANE scores according to Rockwood grade or if concomitant pathology was treated. Conclusions: AA-CCR with free tendon grafts resulted in good clinical outcomes and a high rate of return to preinjury activity level. RLOR did not correlate with return to preinjury activity level. Concomitant pathology that required treatment did not adversely affect outcomes. Return to preinjury activity level may be a more clinically relevant outcome measure than radiographic maintenance of acromioclavicular joint reduction. Level of Evidence: IV (Case Series).
| Original language | English |
|---|---|
| Pages (from-to) | 1086-1095.e1 |
| Journal | Arthroscopy - Journal of Arthroscopic and Related Surgery |
| Volume | 37 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - Apr 2021 |
Bibliographical note
Publisher Copyright:© 2020
Funding
The authors report the following potential conflicts of interest or sources of funding: R.F.W. reports other from Orthonet, outside the submitted work. R.J.W. reports other from Pristine Surgical, other from Cymedica, personal fees from Arthrex, other from Gramercy Extremity Orthopedics, other from Histogenics, personal fees from JRF Ortho, personal fees from Lipogems, and other from RecoverX, outside the submitted work. S.A.R. reports personal fees from Advance Medical, and other from Ortho RTI, outside the submitted work. A.A.A. reports other from Pristine Surgical and other from Rom3, outside the submitted work. J.S.D. reports personal fees and other from Arthrex, personal fees from Thieme, personal fees from Limvatec, and personal fees from Wolters Kluwer Health, outside the submitted work; board or committee member, American Shoulder and Elbow Surgeons; and editorial or governing board, Journal of Shoulder and Elbow Surgeons. D.S.D. reports personal fees and other from Biomet, personal fees from Thieme, personal fees from Wright Medical Technology, and personal fees from Zimmer, outside the submitted work. He is also is a board or committee member for the AAOS and the American Shoulder and Elbow Surgeons and on the editorial or governing board for Springer. L.V.G. reports personal fees and other from Biomet, fees and other from Exactech, personal fees and other from Imagen, other from Responsive Arthroscopy, and personal fees from Smith & Nephew, outside the submitted work; and editorial or governing board, HSS Journal. F.A.C. reports personal fees from Arthrex, personal fees and other from Saunders/Mosby-Elsevier, and personal fees and other from Wolters Kluwer Health-Lippincott Williams & Wilkins, outside the submitted work; Journal of Shoulder and Elbow Surgeons, editorial or governing board; and American Shoulder and Elbow Surgeons, board or committee member. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
| Funders | Funder number |
|---|---|
| Gramercy Extremity Orthopedics | |
| Ortho RTI | |
| Wolters Kluwer Health-Lippincott Williams & Wilkins | |
| American Association of Orthopaedic Surgeons | |
| Arthrex | |
| American Shoulder and Elbow Surgeons |
ASJC Scopus Subject Areas
- Orthopedics and Sports Medicine