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Updated: May 14, 2026

Anterior Capsular Reconstruction with Human Dermal Allograft for Irreparable Subscapularis Tears
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Anterior Capsular Reconstruction with Human Dermal Allograft for Irreparable Subscapularis Tears

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Surgical Timing After Acromioclavicular Joint Separation: Association With Clinical Outcomes.

Mallory B Lane1, Jacob Siahaan1, James M Gregory1

  • 1Department of Orthopedic Surgery, The University of Texas Health Science Center at Houston, McGovern Medical School, Houston, Texas, USA.

Orthopaedic Journal of Sports Medicine
|May 13, 2026
PubMed
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Delayed surgery for acromioclavicular joint (ACJ) separations is linked to worse outcomes. Both ACJ repair and reconstruction showed increased complications and revisions when surgical management was postponed. Early intervention may improve results for ACJ dislocations.

Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Trauma Surgery

Background:

  • Acromioclavicular joint (ACJ) separation treatment lacks provider consensus, especially for high-grade injuries.
  • The impact of surgical timing on clinical outcomes for ACJ injuries remains unclear.

Purpose of the Study:

  • To investigate the relationship between the time to surgery and clinical outcomes for ACJ dislocations.
  • To compare complication and revision rates based on surgical timing for ACJ repair and reconstruction.

Main Methods:

  • A retrospective cohort study (Level 3 evidence) analyzed a nationwide insurance claims database.
  • Patients with ACJ dislocations undergoing surgical repair or reconstruction were categorized into four temporal subgroups based on time from injury to surgery.
  • Clinical outcomes including complication, infection, and fracture rates were compared between subgroups using chi-square tests.
Keywords:
acromioclavicular jointacromioclavicular joint reconstructionacromioclavicular joint repairacromioclavicular joint separation

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Main Results:

  • A total of 13,194 patients were included, with 8,639 undergoing surgery within 4 weeks.
  • For ACJ repair, adverse outcomes increased with delayed surgery.
  • For ACJ reconstruction, revision and complication rates rose as surgical management was delayed.

Conclusions:

  • Delayed surgical management for ACJ dislocations is associated with increased adverse clinical outcomes.
  • Both ACJ repair and reconstruction subgroups demonstrated worsening outcomes with postponed surgery.
  • Further research is needed to identify patient subgroups that benefit from early surgical intervention.