Midterm Functional Outcomes after Arthroscopically Assisted Stabilization for Acute Versus Chronic Type 5...

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomechanical Engineering

Background:

• Limited evidence exists for comparative functional outcomes of acromioclavicular joint (ACJ) stabilization in acute versus chronic high-grade injuries.
• High-grade ACJ injuries require effective stabilization techniques to restore shoulder function.

Purpose of the Study:

• To compare functional outcomes between arthroscopically assisted ACJ stabilization for acute and chronic isolated type 5 ACJ injuries.
• To test the hypothesis that similar functional outcomes would be achieved at midterm follow-up.

Main Methods:

• A cohort study (Level of evidence, 3) analyzed 82 patients with isolated acute or chronic type 5 ACJ injuries.
• Patients underwent ACJ stabilization using coracoclavicular (CC) suspensory fixation and AC cerclage, with chronic cases receiving gracilis autograft augmentation.
• Functional outcomes were assessed using Constant-Murley (CM), ASES, Nottingham Clavicle (NC), and VAS pain scores at a minimum 2-year follow-up.

Main Results:

• No significant differences were observed in CM, ASES, or NC scores between acute and chronic injury groups at a mean follow-up of 5.5 years.
• Visual analog scale (VAS) pain scores and subjective satisfaction with cosmetic appearance were also similar between groups.
• Failure rates requiring revision surgery were comparable: 9.3% in the acute group and 7.1% in the chronic group.

Conclusions:

• Arthroscopically assisted ACJ stabilization for acute type 5 ACJ injuries provides comparable midterm functional outcomes to delayed surgery with biological augmentation.
• The technique using CC suspensory fixation and AC cerclage is effective for both acute and chronic high-grade ACJ injuries.
• Similar patient satisfaction and failure rates support the efficacy of this stabilization method regardless of injury timing.