Low short-term complication rates following acromioclavicular joint surgery: a large database study

Area of Science:

• Orthopedic Surgery
• Musculoskeletal Injuries
• Surgical Outcomes Research

Background:

• Acromioclavicular (AC) joint injuries constitute about 11% of shoulder injuries.
• Severe AC joint injuries are treated surgically using methods like hook-plating, button fixation, and graft reconstruction.
• While long-term complications are documented, short-term outcomes and risk factors for AC joint surgery remain less understood.

Purpose of the Study:

• To investigate the short-term outcomes of AC joint surgery.
• To identify comprehensive complication data following AC joint surgical interventions.
• To elucidate significant risk factors associated with adverse events after AC joint surgery.

Main Methods:

• Utilized the American College of Surgeons National Surgical Quality Improvement Program database (2010-2023).
• Identified patients undergoing AC joint surgery (CPT codes 23550, 23552, 21320) and analyzed 30-day postoperative outcomes.
• Employed multivariate logistic regression and operative time threshold analysis to determine complication risk factors.

Main Results:

• A total of 13,117 patients underwent AC joint surgery with an overall adverse event rate of 2.7%.
• Surgical site infection (1.2%) and return to operating room (1%) were the most frequent complications.
• Operations exceeding 148 minutes were associated with significantly increased complication risk (P < .001).
• Key risk factors included operative time, chronic obstructive pulmonary disease, steroid use, dialysis, bleeding disorders, and type 1 diabetes.

Conclusions:

• AC joint surgery demonstrates favorable short-term complication rates.
• Comorbidities like type 1 diabetes and COPD significantly elevate the risk of adverse events.
• Preoperative counseling for high-risk patients and further research into operative time and patient management are recommended.