Conversion to anatomic coracoclavicular ligament reconstruction (ACCR) shows similar clinical outcomes compared to successful non-operative treatment in chronic primary type III to V acromioclavicular joint injuries.
Acromioclavicular Joint
/ injuries
Adult
Conservative Treatment
/ methods
Female
Follow-Up Studies
Humans
Joint Dislocations
/ surgery
Ligaments, Articular
/ surgery
Male
Middle Aged
Outcome Assessment, Health Care
Postoperative Period
Plastic Surgery Procedures
/ methods
Retrospective Studies
Shoulder
/ surgery
Shoulder Dislocation
/ surgery
Treatment Outcome
Young Adult
AC joint
ACCR
Acromioclavicular joint injury
Anatomic coracoclavicular ligament reconstruction
conservative treatment
Journal
Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
ISSN: 1433-7347
Titre abrégé: Knee Surg Sports Traumatol Arthrosc
Pays: Germany
ID NLM: 9314730
Informations de publication
Date de publication:
Jul 2021
Jul 2021
Historique:
received:
29
03
2020
accepted:
14
07
2020
pubmed:
28
7
2020
medline:
21
7
2021
entrez:
26
7
2020
Statut:
ppublish
Résumé
To compare the clinical outcomes of patients who underwent successful nonoperative treatment for type III-V acromioclavicular joint (ACJ) injuries to those who eventually required conversion to anatomic coracoclavicular ligament reconstruction (ACCR) at a minimum 5-year follow-up. Patients with primary, chronic type III-V ACJ injuries who either underwent successful conservative treatment or conversion to ACCR after failing a trail of conservative management between 2003 and 2014 with a minimum 5-year follow-up were included in the study. Clinical outcome measures comprised the American Shoulder and Elbow Surgeons (ASES) and Simple Shoulder Test (SST) score, collected preoperatively and at final visit for the ACCR group. Outcome scores for patients with successful conservative treatment were only collected at final visit. A Self- Assessment Numeric Evaluation (SANE) score was obtained at terminal follow-up for both groups. Twenty-two patients (mean age: 40.1 ± 15.6 years) with successful nonoperative treatment and twenty-one patients (mean age: 43.6 ± 12.0 years) who required conversion to ACCR were included in the study. At final follow-up, patients with successful non-operative treatment achieved similar ASES (93.0±12.0NonOP vs. 86.1±16.8ACCR), SST (11.2±1.4NonOP vs. 10.7±2.0ACCR) and SANE scores (80.9±19.7NonOPvs. 90.5±14.7ACCR) compared to those who were converted to ACCR. Additionally, patients who underwent conversion to ACCR showed significant improvement in ASES (49.8±18.1pre vs. 86.1±16.8post; Δ36.3±19.7) and SST scores (6.5±3.2prevs. 10.7±2.0post; Δ4.2±4.0) from pre- to postoperative. At a minimum 5-year follow-up, patients with successful non-operative treatment for type III-V ACJ injuries achieved similar clinical outcomes compared to those who were converted to ACCR. In patients with chronic severe ACJ dislocation a trial of conservative treatment may be attempted, astime from injuryto eventual conversion to ACCR had no significant influence on postoperative clinical outcomes. Level IV.
Identifiants
pubmed: 32710143
doi: 10.1007/s00167-020-06159-2
pii: 10.1007/s00167-020-06159-2
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2264-2271Références
Beitzel K, Cote MP, Apostolakos J, Solovyova O, Judson CH, Ziegler CG et al (2013) Current concepts in the treatment of acromioclavicular joint dislocations. Arthroscopy 29:387–397
doi: 10.1016/j.arthro.2012.11.023
Beitzel K, Mazzocca AD, Bak K, Itoi E, Kibler WB, Mirzavan R et al (2014) ISAKOS upper extremity committee consensus statement on the need for diversification of the Rockwood classification for acromioclavicular joint injuries. Arthroscopy 30:271–278
doi: 10.1016/j.arthro.2013.11.005
Berthold DP, Muench LN, Dyrna F, Uyeki CL, Cote MP, Imhoff AB et al (2020) Radiographic alterations in clavicular bone tunnel width following anatomic coracoclavicular ligament reconstruction (ACCR) for chronic acromioclavicular joint injuries. Knee Surg Sports Traumatol Arthrosc. https://doi.org/10.1007/s00167-020-05980-z
doi: 10.1007/s00167-020-05980-z
pubmed: 32710143
Carbone S, Postacchini R, Gumina S (2015) Scapular dyskinesis and SICK syndrome in patients with a chronic type III acromioclavicular dislocation. Results of rehabilitation. Knee Surg Sports Traumatol Arthrosc 23:1473–1480
doi: 10.1007/s00167-014-2844-5
Carofino BC, Mazzocca AD (2010) The anatomic coracoclavicular ligament reconstruction: surgical technique and indications. J Shoulder Elbow Surg 19:37–46
doi: 10.1016/j.jse.2010.01.004
Cote MP, Wojcik KE, Gomlinski G, Mazzocca AD (2010) Rehabilitation of acromioclavicular joint separations: operative and nonoperative considerations. Clin Sports Med 29(213–228):vii
Dunphy TR, Damodar D, Heckmann ND, Sivasundaram L, Omid R, Hatch GF 3rd (2016) Functional outcomes of type V acromioclavicular injuries with nonsurgical treatment. J Am Acad Orthop Surg 24:728–734
doi: 10.5435/JAAOS-D-16-00176
Dyrna F, Berthold DP, Feucht MJ, Muench LN, Martetschlager F, Imhoff AB et al (2019) The importance of biomechanical properties in revision acromioclavicular joint stabilization: a scoping review. Knee Surg Sports Traumatol Arthrosc. https://doi.org/10.1007/s00167-019-05742-6
doi: 10.1007/s00167-019-05742-6
pubmed: 31624902
Frank RM, Cotter EJ, Leroux TS, Romeo AA (2019) Acromioclavicular joint injuries: evidence-based treatment. J Am Acad Orthop Surg. https://doi.org/10.5435/JAAOS-D-17-00105
doi: 10.5435/JAAOS-D-17-00105
pubmed: 31008872
Gowd AK, Liu JN, Cabarcas BC, Cvetanovich GL, Garcia GH, Manderle BJ et al (2019) Current concepts in the operative management of acromioclavicular dislocations: a systematic review and meta-analysis of operative techniques. Am J Sports Med 47:2745–2758
doi: 10.1177/0363546518795147
Gumina S, Carbone S, Postacchini F (2009) Scapular dyskinesis and SICK scapula syndrome in patients with chronic type III acromioclavicular dislocation. Arthroscopy 25:40–45
doi: 10.1016/j.arthro.2008.08.019
Izadpanah K, Weitzel E, Honal M, Winterer J, Vicari M, Maier D et al (2012) In vivo analysis of coracoclavicular ligament kinematics during shoulder abduction. Am J Sports Med 40:185–192
doi: 10.1177/0363546511423015
Kibler WB, Sciascia A (2010) Current concepts: scapular dyskinesis. Br J Sports Med 44:300–305
doi: 10.1136/bjsm.2009.058834
Korsten K, Gunning AC, Leenen LP (2014) Operative or conservative treatment in patients with Rockwood type III acromioclavicular dislocation: a systematic review and update of current literature. Int Orthop 38:831–838
doi: 10.1007/s00264-013-2143-7
Lippitt SB, Harryman DT, Matsen FA (1993) A practical tool for evaluating function: the simple shoulder test. In: Matsen FA, Fu FH, Hawkins RJ (eds) The shoulder: a balance of mobility and stability. American Academy of Orthopaedic Surgeons, Rosemont, IL, pp 501–518
Mazzocca AD, Arciero RA, Bicos J (2007) Evaluation and treatment of acromioclavicular joint injuries. Am J Sports Med 35:316–329
doi: 10.1177/0363546506298022
Mazzocca AD, Conway JE, Johnson S, Rios CG, Dumonski ML, Santangelo SA et al (2004) The anatomic coracoclavicular ligament reconstruction. Oper Tech Sports Med 12:56–61
doi: 10.1053/j.otsm.2004.04.001
Millett PJ, Horan MP, Warth RJ (2015) Two-year outcomes after primary anatomic coracoclavicular ligament reconstruction. Arthroscopy 31:1962–1973
doi: 10.1016/j.arthro.2015.03.034
Moatshe G, Kruckeberg BM, Chahla J, Godin JA, Cinque ME, Provencher MT et al (2018) Acromioclavicular and coracoclavicular ligament reconstruction for acromioclavicular joint instability: a systematic review of clinical and radiographic outcomes. Arthroscopy 34(1979–1995):e1978
Muench LN, Kia C, Jerliu A, Murphy M, Berthold DP, Cote MP et al (2019) Functional and radiographic outcomes after anatomic coracoclavicular ligament reconstruction for type III/V acromioclavicular joint injuries. Orthop J Sports Med 7:2325967119884539
doi: 10.1177/2325967119884539
Nissen CW, Chatterjee A (2007) Type III acromioclavicular separation: results of a recent survey on its management. Am J Orthop (Belle Mead NJ) 36:89–93
Petri M, Warth RJ, Greenspoon JA, Horan MP, Abrams RF, Kokmeyer D et al (2016) Clinical results after conservative management for grade III acromioclavicular joint injuries: does eventual surgery affect overall outcomes? Arthroscopy 32:740–746
doi: 10.1016/j.arthro.2015.11.024
Richards R, An KN, Bigliani LU, Friedman RJ, Gartsman GM, Gristina AG et al (1994) A standardized method for the assessment of shoulder function. J Shoulder Elbow Surg 3:347–352
doi: 10.1016/S1058-2746(09)80019-0
Rockwood CA (1984) Injuries to the acromioclavicular joint: subluxations and dislocations about the shoulder. In: RC A, Green DP (eds) Fractures in adults. J. B. Lippincott, Philadelphia, pp 860–910
Seo Y-J, Yoo Y-S, Noh K-C, Song S-Y, Lee Y-B, Kim H-J et al (2012) Dynamic function of coracoclavicular ligament at different shoulder abduction angles: a study using a 3-dimensional finite element model. Arthroscopy 28:778–787
doi: 10.1016/j.arthro.2012.04.001
Smith TO, Chester R, Pearse EO, Hing CB (2011) Operative versus non-operative management following Rockwood grade III acromioclavicular separation: a meta-analysis of the current evidence base. J Orthop Traumatol 12:19–27
doi: 10.1007/s10195-011-0127-1
Tamaoki MJ, Lenza M, Matsunaga FT, Belloti JC, Matsumoto MH, Faloppa F (2019) Surgical versus conservative interventions for treating acromioclavicular dislocation of the shoulder in adults. Cochrane Database Syst Rev 10:CD007429
pubmed: 31604007
Tischer T, Salzmann GM, El-Azab H, Vogt S, Imhoff AB (2009) Incidence of associated injuries with acute acromioclavicular joint dislocations types III through V. Am J Sports Med 37:136–139
doi: 10.1177/0363546508322891
Trainer G, Arciero RA, Mazzocca AD (2008) Practical management of grade III acromioclavicular separations. Clin J Sport Med 18:162–166
doi: 10.1097/JSM.0b013e318169f4c1
Verstift DE, Welsink CL, Spaans AJ, van den Bekerom MPJ (2019) Return to sport after surgical treatment for high-grade (Rockwood III–VI) acromioclavicular dislocation. Knee Surg Sports Traumatol Arthrosc 27:3803–3812
doi: 10.1007/s00167-019-05528-w
Williams GN, Gangel TJ, Arciero RA, Uhorchak JM, Taylor DC (1999) Comparison of the single assessment numeric evaluation method and two shoulder rating scales. Am J Sports Med 27:214–221
doi: 10.1177/03635465990270021701
Xará-Leite F, Andrade R, Moreira PS, Coutinho L, Ayeni OR, Sevivas N et al (2019) Anatomic and non-anatomic reconstruction improves post-operative outcomes in chronic acromio-clavicular instability: a systematic review. Knee Surg Sports Traumatol Arthrosc 27:3779–3796
doi: 10.1007/s00167-019-05408-3