Simone Cerciello1,2, Daniel P Berthold3,4, Colin Uyeki3, Cameron Kia3, Mark P Cote3, Andreas B Imhoff4, Knut Beitzel4,5, Katia Corona6, Augustus D Mazzocca3, Lukas N Muench3,4. 1. Casa di Cura Villa Betania, Rome, Italy. 2. Marrelli Hospital, Crotone, Italy. 3. Department of Orthopaedic Surgery, UConn Health, Farmington, CT, USA. 4. Department of Orthopaedic Sports Medicine, Technical University of Munich, Munich, Germany. 5. Department of Shoulder Surgery, ATOS Clinic, Cologne, Germany. 6. Department of Medicine and Health Sciences Vincenzo Tiberio, University of Molise, Campobasso, Italy. Katia.corona@unimol.it.
Abstract
PURPOSE: To evaluate the clinical and radiographic outcomes of patients undergoing anatomic coracoclavicular ligament reconstruction (ACCR) using free tendon allografts for the treatment of chronic acromioclavicular joint (ACJ) injuries with a minimum 1-year follow-up. METHODS: Patients who underwent ACCR for chronic ACJ injuries between 2003 and 2017 were analyzed. Clinical outcome measures included American Shoulder and Elbow Surgeons (ASES), Constant-Murley (CM), Simple Shoulder Test (SST), and Single Assessment Numerical Evaluation (SANE) scores. Radiographic loss of reduction during follow-up was evaluated by calculating the difference (mm) in the coracoclavicular distance (CCD) of the involved side immediately postoperatively and at terminal follow-up. RESULTS: Forty-two patients (mean age: 42.7 ± 12.8 years) were included in the study with an average follow-up of 3.8 ± 3.1 years (range: 1.1-11.5 years). Patients achieved significant improvement in ASES (50.2 ± 20.1 pre to 85.2 ± 16.3 post), CM (60.2 ± 18.5 pre to 88.2 ± 9.1 post), SST (6.1 ± 3.2 pre to 9.5 ± 3.7 post), and SANE (24.0 ± 25.7 pre to 89.0 ± 12.7 post) scores (P < 0.001, respectively). There were no significant differences in functional improvement when comparing type III and V injuries (n.s.). Mean increase in CCD of the involved side from immediately postoperative to final radiographic follow-up was 4.1 ± 3.9 mm, with no significant correlation to clinical outcomes scores. Complications occurred in 33.3% of cases, with postoperative heterotopic ossification being most frequent (14.3%). CONCLUSION: Patients undergoing ACCR using free tendon allografts for chronic ACJ injuries achieved significant improvement in shoulder function at a mean follow-up of 3.8 years. No correlation was observed between the amount of loss of reduction and clinical outcome scores. Free tendon allografts may be a reliable alternative to autografts in the treatment of chronic ACJ dislocations. LEVEL OF EVIDENCE: IV.
PURPOSE: To evaluate the clinical and radiographic outcomes of patients undergoing anatomic coracoclavicular ligament reconstruction (ACCR) using free tendon allografts for the treatment of chronic acromioclavicular joint (ACJ) injuries with a minimum 1-year follow-up. METHODS:Patients who underwent ACCR for chronic ACJ injuries between 2003 and 2017 were analyzed. Clinical outcome measures included American Shoulder and Elbow Surgeons (ASES), Constant-Murley (CM), Simple Shoulder Test (SST), and Single Assessment Numerical Evaluation (SANE) scores. Radiographic loss of reduction during follow-up was evaluated by calculating the difference (mm) in the coracoclavicular distance (CCD) of the involved side immediately postoperatively and at terminal follow-up. RESULTS: Forty-two patients (mean age: 42.7 ± 12.8 years) were included in the study with an average follow-up of 3.8 ± 3.1 years (range: 1.1-11.5 years). Patients achieved significant improvement in ASES (50.2 ± 20.1 pre to 85.2 ± 16.3 post), CM (60.2 ± 18.5 pre to 88.2 ± 9.1 post), SST (6.1 ± 3.2 pre to 9.5 ± 3.7 post), and SANE (24.0 ± 25.7 pre to 89.0 ± 12.7 post) scores (P < 0.001, respectively). There were no significant differences in functional improvement when comparing type III and V injuries (n.s.). Mean increase in CCD of the involved side from immediately postoperative to final radiographic follow-up was 4.1 ± 3.9 mm, with no significant correlation to clinical outcomes scores. Complications occurred in 33.3% of cases, with postoperative heterotopic ossification being most frequent (14.3%). CONCLUSION:Patients undergoing ACCR using free tendon allografts for chronic ACJ injuries achieved significant improvement in shoulder function at a mean follow-up of 3.8 years. No correlation was observed between the amount of loss of reduction and clinical outcome scores. Free tendon allografts may be a reliable alternative to autografts in the treatment of chronic ACJ dislocations. LEVEL OF EVIDENCE: IV.
Authors: Lukas N Muench; Daniel P Berthold; Colin Uyeki; Cameron Kia; Mark P Cote; Andreas B Imhoff; Knut Beitzel; Katia Corona; Augustus D Mazzocca; Simone Cerciello Journal: Knee Surg Sports Traumatol Arthrosc Date: 2020-07-24 Impact factor: 4.342
Authors: Felix Dyrna; Daniel P Berthold; Matthias J Feucht; Lukas N Muench; Frank Martetschläger; Andreas B Imhoff; Augustus D Mazzocca; Knut Beitzel Journal: Knee Surg Sports Traumatol Arthrosc Date: 2019-10-17 Impact factor: 4.342
Authors: Marco-Christopher Rupp; Pavel M Kadantsev; Sebastian Siebenlist; Maximilian Hinz; Matthias J Feucht; Jonas Pogorzelski; Bastian Scheiderer; Andreas B Imhoff; Lukas N Muench; Daniel P Berthold Journal: Knee Surg Sports Traumatol Arthrosc Date: 2022-04-22 Impact factor: 4.114
Authors: Maxwell T Trudeau; Jonathan J Peters; Benjamin C Hawthorne; Ian J Wellington; Matthew R LeVasseur; Michael R Mancini; Elifho Obopilwe; Giovanni Di Giacomo; Simone Cerciello; Augustus D Mazzocca Journal: Orthop J Sports Med Date: 2022-09-26