Background: We have been performing arthroscopically assisted acromioclavicular joint (ACJ) reconstruction using synthetic ligament for acute Rockwood grade III-Ⅴ ACJ separation since 2002. Further, synthetic ligament fixation has been reinforced by additional stapling since 2008. The purpose of this study was to evaluate clinical outcomes of this procedure and compare postoperative X-ray findings between patients with and without stapling.
Methods: Since 2002, 42 patients underwent the index surgery and 38 patients (32 male and 6 female) who were followed for more than 12 months after surgery were investigated in this study. The average age of surgery was 42.4 years old, and the mean follow up period was 18.9 months. The ACJ separation was reduced and stabilized by a synthetic ligament passed around the coracoid process arthroscopically. In addition, reduced clavicle was augmented by the transferred Coracoacromial ligament released from the acromial undersurface. Clinical outcome using JOA and JSS-ACJ scores and postoperative X-ray findings, including ACJ alignment, were assessed at the final follow-up using the following criteria: excellent, no side-to-side difference compared with normal side; good, subluxation with less than 50% width of the acromion; fair, subluxation with less than 100% width of the acromion; poor, dislocation which means that the clavicle displaced beyond the acromion width.
Results: The mean postoperative JOA score significantly improved from 75.4 to 97.4 and the mean JSS-ACJ score was 95.1 postoperatively. Twenty patients demonstrated excellent reduction and 8 patients were estimated as good and 8 as fair on X-rays. Regarding clinical outcomes and X-ray findings, there was no significant difference between patients with stapling and without.
Conclusion: Arthroscopically assisted ACJ reconstruction demonstrated acceptable outcomes in terms of shoulder function and X-ray findings. However, further technological modification can be required in order to achieve more optimal reduction.
