Early clinical follow-up after arthroscopy-assisted anatomic coracoclavicular ligament reconstruction using tendon allograft for acute high-grade acromioclavicular joint dislocations
10.3969/j.issn.1000-6710.2024.11.001
- VernacularTitle:肩关节镜辅助下异体肌腱移植喙锁韧带重建手术治疗急性重度肩锁关节脱位的早期临床随访研究
- Author:
Fenglong LI
1
;
Jianhao XIE
1
;
Yang ZHAO
1
;
Chunyan JIANG
1
;
Yiming ZHU
1
Author Information
1. 首都医科大学附属北京积水潭医院运动医学科(北京 100035);北京市创伤骨科研究所(北京 100035)
- Publication Type:Journal Article
- Keywords:
acromioclavicular joint dislocation;
tendon allograft;
coracoclavicular ligament recon-struction
- From:
Chinese Journal of Sports Medicine
2024;43(11):855-861
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the clinical results after arthroscopy-assisted anatomic coracoclavicu-lar ligament reconstruction(AA-ACCR)using tendon allograft for acute high-grade acromioclavicular joint dislocations.Methods Patients undergoing primary AA-ACCR with tendon allograft for Rockwood type Ⅲ/Ⅴ acromioclavicular joint dislocations between January 2015 and January 2017 were analyzed retrospectively.The coracoclavicular distance(CCD)was obtained on radiographs pre-and post-opera-tively,as well as 6 weeks after the operation and during the final follow-up,and complications were recorded.Moreover,before the operation and during the final follow-up,all patients were evaluated shoulder pain and function using the American Shoulder and Elbow Surgeon score(ASES)and Visual Analogue Scale(VAS).Results In total,21 patients were included for evaluation with a minimum of 6-month follow-up(range,6-18 months).According to preoperative X ray,8 and 13 patients suffered from Rockwood type Ⅲ and V acromioclavicular dislocation,respectively.CCD decreased significantly six weeks postoperatively(8.6±2.6 mm)and at the final follow-up(11.7±3.5 mm)compared with the preoperative value(19.7±4.5 mm,P＜0.01).However,CCD at the latter time points was signifi-cantly higher than right after the operation(7.9±2.5 mm,P＜0.01).Furthermore,CCD increased sig-nificantly at the final follow-up compared with six weeks postoperatively(P＜0.01).At the final follow-up,significant improvement was observed in the average VAS and ASES scores(P＜0.01).Moreover,at the final follow-up,10 out of 21 patients(48％)experienced a loss of reduction,including 3 fail-ures in operation and 7 in later restoration.All patients had both medial and lateral clavicular tunnel widening.However,no fracture of the coracoid/clavicle or other complications were recorded.Conclu-sion AA-ACCR with tendon allograft for acute high-grade acromioclavicular joint dislocations contrib-utes to significant improvement in clinical and radiographic outcomes in the early follow-up.Although the loss of reduction rate is relatively high(48％),it is a safe method without obvious complications.
