Conversion to anatomic coracoclavicular ligament reconstruction (ACCR) shows similar clinical outcomes compared to successful non-operative treatment in chronic primary type III to V acromioclavicular joint injuries.
Knee Surg Sports Traumatol Arthrosc
; 29(7): 2264-2271, 2021 Jul.
Article
em En
| MEDLINE
| ID: mdl-32710143
ABSTRACT
PURPOSE:
To compare the clinical outcomes of patients who underwent successful nonoperative treatment for type III-V acromioclavicular joint (ACJ) injuries to those who eventually required conversion to anatomic coracoclavicular ligament reconstruction (ACCR) at a minimum 5-year follow-up.METHODS:
Patients with primary, chronic type III-V ACJ injuries who either underwent successful conservative treatment or conversion to ACCR after failing a trail of conservative management between 2003 and 2014 with a minimum 5-year follow-up were included in the study. Clinical outcome measures comprised the American Shoulder and Elbow Surgeons (ASES) and Simple Shoulder Test (SST) score, collected preoperatively and at final visit for the ACCR group. Outcome scores for patients with successful conservative treatment were only collected at final visit. A Self- Assessment Numeric Evaluation (SANE) score was obtained at terminal follow-up for both groups.RESULTS:
Twenty-two patients (mean age 40.1 ± 15.6 years) with successful nonoperative treatment and twenty-one patients (mean age 43.6 ± 12.0 years) who required conversion to ACCR were included in the study. At final follow-up, patients with successful non-operative treatment achieved similar ASES (93.0±12.0NonOP vs. 86.1±16.8ACCR), SST (11.2±1.4NonOP vs. 10.7±2.0ACCR) and SANE scores (80.9±19.7NonOPvs. 90.5±14.7ACCR) compared to those who were converted to ACCR. Additionally, patients who underwent conversion to ACCR showed significant improvement in ASES (49.8±18.1pre vs. 86.1±16.8post; Δ36.3±19.7) and SST scores (6.5±3.2prevs. 10.7±2.0post; Δ4.2±4.0) from pre- to postoperative.CONCLUSION:
At a minimum 5-year follow-up, patients with successful non-operative treatment for type III-V ACJ injuries achieved similar clinical outcomes compared to those who were converted to ACCR. In patients with chronic severe ACJ dislocation a trial of conservative treatment may be attempted, astime from injuryto eventual conversion to ACCR had no significant influence on postoperative clinical outcomes. LEVEL OF EVIDENCE Level IV.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Articulação Acromioclavicular
/
Procedimentos de Cirurgia Plástica
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Tratamento Conservador
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Ligamentos Articulares
Tipo de estudo:
Observational_studies
/
Prognostic_studies
Limite:
Adult
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Female
/
Humans
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Male
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Middle aged
Idioma:
En
Revista:
Knee Surg Sports Traumatol Arthrosc
Assunto da revista:
MEDICINA ESPORTIVA
/
TRAUMATOLOGIA
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Estados Unidos