Chronic acromioclavicular dislocations: multidirectional stabilization without grafting

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Traumatology

Background:

• Chronic acromioclavicular (AC) joint dislocations present a significant challenge in orthopedic practice.
• Surgical management aims to restore stability and function, but various techniques have associated drawbacks.

Purpose of the Study:

• To evaluate the clinical and radiological outcomes of surgical treatment for chronic AC dislocations using a triple button device.
• To assess the efficacy of AC joint augmentation with this specific surgical technique.

Main Methods:

• Retrospective analysis of 21 patients with chronic AC dislocations.
• Utilized bilateral-weighted Zanca and Alexander views for radiographic assessment.
• Clinical evaluation included the Constant score (CS) and Acromioclavicular Joint Instability Scoring System (ACJI).

Main Results:

• Mean follow-up of 49.7 months showed high CS (95.2) and ACJI (89.7) scores, comparable to the uninjured shoulder.
• Significant radiological improvement in coracoclavicular distance (12.8 mm to 8.5 mm) and AC distance (7.8 mm to 0.99 mm).
• No significant difference in outcomes compared to the contralateral healthy shoulder; osteoarthritis did not correlate with poorer results.

Conclusions:

• The triple button device is a viable and acceptable surgical option for chronic AC joint dislocations.
• The technique is straightforward, avoids the need for grafts, and does not require hardware removal.
• This method presents a low complication rate and effective restoration of joint stability and function.