Reconstruction of Acute Acromioclavicular (AC) Joint Dislocations with or without Tendon Graft: a Retrospective Comparative Study

Abstract

Background: Reconstructions of acute acromioclavicular (AC) dislocations have been thought to result in superior<br />outcomes than chronic dislocations. The use of tendon graft in reconstructions has demonstrated favorable<br />biomechanical properties. To determine whether utilizing tendon graft during repair of acute AC dislocations results in<br />superior outcomes and lower complication rate.<br />Methods: A retrospective review of AC reconstructions was conducted. Reconstructions performed within 3 weeks of<br />injury were included. Inclusion criteria included age over 18, grade 3-5 AC joint separation, and no previous ipsilateral<br />shoulder injury. Primary outcome measure was radiographic loss of reduction. Secondary outcomes included ASES<br />and SANE scores.<br />Results: Of 47 reconstructions of acute AC joint separations, 35 utilized fixation without a tendon graft, while 12<br />underwent an anatomic reconstruction with tendon graft. Repairs without the use of graft resulted in 8 (23%) cases<br />of loss of reduction, while tendon graft augmented repairs resulted in 5 (42%). This difference was not statistically<br />significant (P = 0.22). No patients required reoperation. There was no statistical difference in the ASES and SANE<br />scores between the two groups. Furthermore, we found no significant difference in ASES or SANE scores in patients<br />who maintained reduction postoperatively versus those that lost reduction.<br />Conclusion: A greater but not statistically significant rate of loss of reduction was observed in the group reconstructed<br />with the use of a tendon graft. Further research is needed to determine whether the use of tendon graft is beneficial in<br />the treatment of acute AC joint separations.<br />Level of evidence: IV