Surgical treatment of acromioclavicular dislocation with LARS artificial ligament

Abstract

The choice of the most appropriate procedure for surgical treatment of type IV–V and VI dislocations of the acromioclavicular joint according to Rockwood’s classification has always been troublesome because of complications such as residual instability of the joint, delayed arthrosis of the A-C, delayed osteolysis of the clavicle, host intolerance towards artificial ligaments and because of the need of early mobilization of the affected limb. In our study, 17 male patients, ranging in age from 21 to 79 years and affected by A-C dislocation grade IV and V, both acute and chronic, underwent surgical reconstruction of the A-C joint capsule and extra-articular ligaments with ligament augmentation and reconstruction system (LARS) artificial ligament. Following surgery, their affected limb was braced for 3 days and thereafter all patients began an early active and passive mobilization programme. Patients eventually all returned to their previous working and recreational activities. Throughout thorough clinical and radiographic evaluation and the use of both Constant score and Simple Shoulder test, the aim of our study is to prove that at mid-term follow-up, the reconstruction of the conoid and trapezoid ligaments with LARS is a valid and safe alternative to other procedures.