Philip-C Nolte1, Joseph J Ruzbarsky2, Bryant P Elrick3, Thomas Woolson3, Kaare S Midtgaard4, Peter J Millett5. 1. Steadman Philippon Research Institute, 181 West Meadow Drive, Suite 400, Vail, CO 81657, USA; BG Trauma Center Ludwigshafen at the University of Heidelberg, Clinic for Trauma and Orthopaedic Surgery, Ludwig-Guttmann-Strasse 13, 67071 Ludwigshafen, Germany. 2. The Steadman Clinic, 181 West Meadow Drive, Suite 1000, Vail, CO 81657, USA. 3. Steadman Philippon Research Institute, 181 West Meadow Drive, Suite 400, Vail, CO 81657, USA. 4. Steadman Philippon Research Institute, 181 West Meadow Drive, Suite 400, Vail, CO 81657, USA; Division of Orthopaedic Surgery, Oslo University Hospital, 0372 Oslo, Norway; Norwegian Armed Forces Joint Medical Services, 2058 Sessvollmoen, Forsvarsvegen 75, Norway. 5. Steadman Philippon Research Institute, 181 West Meadow Drive, Suite 400, Vail, CO 81657, USA; The Steadman Clinic, 181 West Meadow Drive, Suite 1000, Vail, CO 81657, USA. Electronic address: drmillett@thesteadmanclinic.com.
Abstract
PURPOSE: The purposes of this study were to assess clinical and radiographic outcomes of arthroscopically-assisted, anatomic coracoclavicular ligament reconstruction using tendon allograft (AA-ACCR) for the treatment of Rockwood type III-V injuries at minimum 2-year follow-up, and to perform subgroup analyses of clinical and radiographic outcomes for acute vs. chronic and type III vs. type IV-V injuries. METHODS: In this retrospective study of prospectively collected data, patients that underwent primary AA-ACCR for the treatment of type III-V dislocations and had minimum 2-year follow-up were included. Pre- and postoperatively patient-reported outcome scores (PROs) were collected including American Shoulder and Elbow Surgeons (ASES) score, Single Numeric Assessment Evaluation (SANE) score, Short Form-12 Physical Component Summary (SF-12 PCS), Quick Disabilities of the Arm Shoulder and Hand (QuickDASH) score, and patient satisfaction. Pre- and postoperative CC distance (CCD) was obtained. PROs and CCD were reported for the total cohort and for the subgroups. Complication and revision rates were demonstrated. RESULTS: A total of 102 patients (10 women, 92 men) with a mean age of 45.0 years (range, 18-73 years) were included. There were 13 complications (12.7%) resulting in revision surgery. Following exclusion of revised patients, PROs were available for 69 (77.5%). At mean follow-up of 4.7 years (range, 2.0-12.8 years) all PROs improved significantly (P<.001). Median patient satisfaction was 9.0 (IQR, 8.0-10.0). Median pre- to postoperative CCD decreased significantly (P<.001). Subgroup analyses revealed significant improvements in all PROs and CCD from pre- to postoperative for both acute and chronic, and type III and type IV-V dislocations (P<.05) with no significant differences in postoperative PROs and satisfaction between (P>.05). CONCLUSION: AA-ACCR for high-grade AC joint injuries resulted in high postoperative PROs and patient satisfaction with significant improvements from pre- to postoperatively in those who did not undergo revision surgery. Furthermore, subgroup analyses revealed that acute and chronic, and type III and type IV-V injuries benefitted similarly from AA-ACCR.
PURPOSE: The purposes of this study were to assess clinical and radiographic outcomes of arthroscopically-assisted, anatomic coracoclavicular ligament reconstruction using tendon allograft (AA-ACCR) for the treatment of Rockwood type III-V injuries at minimum 2-year follow-up, and to perform subgroup analyses of clinical and radiographic outcomes for acute vs. chronic and type III vs. type IV-V injuries. METHODS: In this retrospective study of prospectively collected data, patients that underwent primary AA-ACCR for the treatment of type III-V dislocations and had minimum 2-year follow-up were included. Pre- and postoperatively patient-reported outcome scores (PROs) were collected including American Shoulder and Elbow Surgeons (ASES) score, Single Numeric Assessment Evaluation (SANE) score, Short Form-12 Physical Component Summary (SF-12 PCS), Quick Disabilities of the Arm Shoulder and Hand (QuickDASH) score, and patient satisfaction. Pre- and postoperative CC distance (CCD) was obtained. PROs and CCD were reported for the total cohort and for the subgroups. Complication and revision rates were demonstrated. RESULTS: A total of 102 patients (10 women, 92 men) with a mean age of 45.0 years (range, 18-73 years) were included. There were 13 complications (12.7%) resulting in revision surgery. Following exclusion of revised patients, PROs were available for 69 (77.5%). At mean follow-up of 4.7 years (range, 2.0-12.8 years) all PROs improved significantly (P<.001). Median patient satisfaction was 9.0 (IQR, 8.0-10.0). Median pre- to postoperative CCD decreased significantly (P<.001). Subgroup analyses revealed significant improvements in all PROs and CCD from pre- to postoperative for both acute and chronic, and type III and type IV-V dislocations (P<.05) with no significant differences in postoperative PROs and satisfaction between (P>.05). CONCLUSION: AA-ACCR for high-grade AC joint injuries resulted in high postoperative PROs and patient satisfaction with significant improvements from pre- to postoperatively in those who did not undergo revision surgery. Furthermore, subgroup analyses revealed that acute and chronic, and type III and type IV-V injuries benefitted similarly from AA-ACCR.