Lukas N Muench1,2, Daniel P Berthold1,2, Colin Uyeki1, Cameron Kia1, Mark P Cote1, Andreas B Imhoff2, Knut Beitzel2,3, Katia Corona4, Augustus D Mazzocca1, Simone Cerciello5,6. 1. Department of Orthopaedic Surgery, UConn Health, Farmington, CT, USA. 2. Department of Orthopaedic Sports Medicine, Technical University of Munich, Munich, Germany. 3. Department of Shoulder Surgery, ATOS Clinic, Cologne, Germany. 4. Department of Medicine, Health Sciences Vincenzo Tiberio. University of Molise, Campobasso, Italy. katiacorona@tiscali.it. 5. Casa di Cura Villa Betania, Rome, Italy. 6. Marrelli Hospital, Crotone, Italy.
Abstract
PURPOSE: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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 OF EVIDENCE: Level IV.
PURPOSE: 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. METHODS: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. RESULTS: 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. CONCLUSION: 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 OF EVIDENCE: Level 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: 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: Simone Cerciello; Daniel P Berthold; Colin Uyeki; Cameron Kia; Mark P Cote; Andreas B Imhoff; Knut Beitzel; Katia Corona; Augustus D Mazzocca; Lukas N Muench Journal: Knee Surg Sports Traumatol Arthrosc Date: 2020-06-30 Impact factor: 4.342
Authors: Stephanie Geyer; Andrea E Achtnich; Andreas Voss; Daniel P Berthold; Patricia M Lutz; Andreas B Imhoff; Frank Martetschläger Journal: Arch Orthop Trauma Surg Date: 2022-02-27 Impact factor: 3.067