Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jul;25(7):1989-1994.
doi: 10.1007/s00167-017-4509-7. Epub 2017 Apr 22.

Open capsular and ligament reconstruction with semitendinosus hamstring autograft successfully controls superior and posterior translation for type V acromioclavicular joint dislocation

Raffaele Garofalo  1 , Enrico Ceccarelli  2 , Alessandro Castagna  3 , Vittorio Calvisi  4 , Brody Flanagin  5 , Marco Conti  3 , Sumant G Krishnan  6
Affiliations

Open capsular and ligament reconstruction with semitendinosus hamstring autograft successfully controls superior and posterior translation for type V acromioclavicular joint dislocation

Raffaele Garofalo et al. Knee Surg Sports Traumatol Arthrosc. 2017 Jul.

Abstract

Purpose: Appropriate surgical management for type V complete acromioclavicular (AC) joint dislocation remains controversial. The purpose of this paper is to retrospectively report the clinical and radiographic outcomes of an open surgical technique consisting for AC joint ligamentous and capsular reconstruction using autologous hamstring tendon grafts and semi-permanent sutures.

Methods: Between January 2005 and December 2011, 32 consecutive patients with symptomatic type V complete AC joint dislocation underwent surgical treatment using the same technique. The median time from injury to surgery was 45 days (range 24-90). The average median postoperative clinical and radiographic follow-up time was 30 months (range 24-33). Clinical outcomes measures included the ASES score, the visual analog score (VAS), and subjective patient satisfaction score. Minimum follow-up was 2 years.

Results: ASES score increased from a median of 38.2 ± 6.2 preoperative to 92.1 ± 4.7 postoperatively (p ≤ 0.05). The median VAS score improved from 62 mm (range 45-100 mm) preoperatively to 8 mm (range 0-20 mm) at final follow-up (p ≤ 0.05). No patient experienced pain or discomfort with either direct palpation of the AC joint or with cross-body adduction. Final radiographs demonstrated symmetric AC joint contour in 25/32 (78%) patients. Seven patients (22%) radiographically demonstrated superior translation of the distal clavicle relative to the superior margin of the acromion but less than 50% of the clavicular width. 30/32 patients (93%) were able to return to their pre-injury level of work and sports activities.

Conclusions: This novel surgical technique using a free graft and braided suture for simultaneous coracoclavicular ligament and AC joint capsular reconstruction successfully controls superior and posterior translations after type V AC joint dislocation and minimizes the incidence of persistent postoperative AC joint subluxation.

Level of evidence: Retrospective case series, Level IV.

Keywords: Acromioclavicular joint; Coracoclavicular ligament; Dislocation; Shoulder; Type V dislocation.

PubMed Disclaimer

References

    1. Am J Sports Med. 2004 Dec;32(8):1929-36 - PubMed
    1. Clin Orthop Relat Res. 2003 Jan;(406):89-96 - PubMed
    1. Am J Sports Med. 2003 Sep-Oct;31(5):648-55 - PubMed
    1. Am J Sports Med. 2012 Mar;40(3):681-5 - PubMed
    1. South Med J. 1963 May;56:486-95 - PubMed