Loss of reduction after coracoclavicular reconstruction did not affect return to activity
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NASHVILLE, Tenn. — Radiographic loss of reduction after arthroscopic-assisted coracoclavicular ligament reconstruction did not affect patients’ ability to return to pre-injury levels of activity, according to presented results.
Using an institutional registry at Hospital for Special Surgery, Joseph D. Lamplot, MD, and colleagues assessed patients who underwent arthroscopic-assisted coracoclavicular ligament reconstruction clinically and their ability to return to pre-injury level of sport or recreational activity.
“Free-tendon allografts were placed through mini-incision, heavy suture was used in all cases as ancillary fixation and, per surgeon preference, excess allograft was brought laterally to reconstruct the [acromioclavicular] AC joint capsule,” Lamplot said in his presentation at the American Orthopaedic Society for Sports Medicine and Arthroscopy Association of North America Combined Meeting.
Lamplot noted treatment was determined a failure if a patient underwent a revision AC joint stabilization surgery, was unable to return to the same high level of activity or had a radiographic loss of reduction.
“Radiographic loss of reduction was determined as a 25% or more increase in the [coracoclavicular] CC distance compared to the contralateral, unaffected side,” Lamplot said.
Researchers had a 67% follow-up rate at a mean of 6 years and a minimum of 2 years, with concomitant scope procedures performed in about half of cases, most of which were labral debridements and rotator cuff debridements.
“Overall, we had three patients undergo revision surgery, we had five that had radiographic loss of reduction and seven that were not able to return to preoperative level of injury,” Lamplot said.
Lamplot noted all patients with radiographic loss of reduction returned to pre-injury activity level and had significantly higher single assessment numeric evaluation scores compared with patients who were unable to return to pre-injury activity level. Patients had no significant differences in outcomes depending on the number of tunnels placed in the clavicle and whether surgeons reconstructed the AC joint capsule with excess graft, according to Lamplot.
“There were no differences in outcomes depending on preoperative grade of injury, either grade III or V, and there was no clinically significant difference when looking at concomitant pathology that was treated at the time of surgery,” Lamplot said.
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Dines JS, et al. Arthroscopic-assisted coracoclavicular ligament reconstruction: Clinical outcomes and return to activity at mean six-year follow-up. Presented at: American Orthopaedic Society for Sports Medicine and Arthroscopy Association of North America Combined Meeting; July 7-11, 2021; Nashville, Tennessee.
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