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Anatomic reconstruction of the coracoclavicular and acromioclavicular ligaments with semitendinosus tendon graft for the treatment of chronic acromioclavicular joint dislocation provides good clinical and radiological results

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To evaluate clinical and radiographic outcomes of anatomical reconstruction of the coracoclavicular and acromioclavicular ligaments with single-strand semitendinosus tendon graft for the treatment of chronic acromioclavicular joint dislocation.

Methods

Patients affected by chronic type III–V acromioclavicular joint dislocations were included. Exclusion criteria were: age under 18 years, concomitant rotator cuff tears, previous surgery to the same shoulder, degenerative changes of the glenohumeral joint, infections, neurologic diseases, patients with a previous history of ligament reconstruction procedures that had required harvesting of the semitendinosus tendon from the ipsilateral or contralateral knee. All patients underwent the same surgical technique and rehabilitation. Primary outcome was the normalized Constant score. Secondary outcomes were: DASH score, radiographic evaluation of loss of reduction and acromioclavicular joint osteoarthritis.

Results

Thirty patients with a mean age of 28.9 ± 8.3 years were included. Mean time to surgery was 12.8 ± 10 months. Mean follow-up was 28.1 ± 2.4 months (range: 24–32). Comparison between pre- and postoperative functional scores showed significant clinical improvement (p < 0.001). Time to surgery was independently associated with a poorer Constant score (p < 0.0001). On radiographs, 4 patients (13.3%) showed asymptomatic partial loss of reduction.

Conclusion

Anatomic reconstruction of coracoclavicular and acromioclavicular ligaments using a semitendinosus tendon graft for the treatment of chronic acromioclavicular joint dislocation provided good clinical and radiological results at minimum 2-year follow-up.

Level of evidence

Level III.

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Authors and Affiliations

  1. Orthopaedics Institute, Fondazione Policilinico A. Gemelli IRCCS, Rome, Italy

    Maristella F. Saccomanno, Fabrizio Mocini, Valeria Vismara & Vincenzo Campana

  2. University of Brescia, Brescia, Italy

    Andrea G. Salvi, Alessandra Scaini & Giuseppe Milano

  3. Department of Bone and Joint Surgery, Spedali Civili, Brescia, Italy

    Giacomo Marchi & Giuseppe Milano

Authors
  1. Maristella F. Saccomanno
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  2. Giacomo Marchi
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  3. Fabrizio Mocini
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Correspondence to Maristella F. Saccomanno.

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Saccomanno, M.F., Marchi, G., Mocini, F. et al. Anatomic reconstruction of the coracoclavicular and acromioclavicular ligaments with semitendinosus tendon graft for the treatment of chronic acromioclavicular joint dislocation provides good clinical and radiological results. Knee Surg Sports Traumatol Arthrosc 29, 2356–2363 (2021). https://doi.org/10.1007/s00167-020-06285-x

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