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Functional and Radiographic Outcomes After Allograft Anatomic Coracoclavicular Ligament Reconstruction.
Sean Baran1, Jeffrey G Belisle, Erin K Granger
1Department of Orthopaedics, University of Utah School of Medicine, Salt Lake City, UT.
Journal of Orthopaedic Trauma
|March 21, 2018
Summary
Anatomic coracoclavicular ligament reconstruction (ACCR) using hamstring allograft without interference screws shows comparable functional and radiographic outcomes. This technique may eliminate the need for interference screws in ACCR, simplifying the procedure.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Trauma Surgery
Background:
- Acromioclavicular joint disruptions are common injuries.
- Anatomic coracoclavicular ligament reconstruction (ACCR) is a surgical option for severe AC joint injuries.
- Interference screw fixation is a common method used in ACCR.
Purpose of the Study:
- To evaluate the functional and radiographic outcomes of ACCR using allograft tendon without interference screw fixation.
- To determine if interference screw fixation is necessary for successful ACCR outcomes.
Main Methods:
- Retrospective study of 17 patients with Rockwood III-V AC joint disruptions.
- Open ACCR utilizing hamstring allograft with suture augmentation and knot fixation.
- Assessment of clinical outcomes (Simple Shoulder Test, ASES scores, VAS pain) and radiographic outcomes.
Main Results:
- Patients achieved good functional outcomes with average SST of 10.8 and ASES of 80.5.
- Average postoperative pain (VAS) was low at 1.8.
- All patients showed clavicle tunnel widening, but clinical significance is undetermined; no screw-related fractures occurred.
Conclusions:
- Open ACCR with hamstring allograft, suture augmentation, and knot fixation provides outcomes comparable to repairs using interference screws.
- Interference screws may not be necessary for ACCR, potentially simplifying the procedure.
- Further comparative studies are needed to confirm these findings.
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