Truly anatomic coracoclavicular ligament reconstruction with 2 Endobutton devices for acute Rockwood type V acromioclavicular joint dislocations: 5-year findings.

Abstract

BACKGROUND\nTo date mid-term clinical and radiologic outcomes of treatment for acute Rockwood type V acromioclavicular (AC) joint dislocations using 2 Endobutton (Smith & Nephew Inc., Andover, MA, USA) devices have not been reported in the literature.\n\n\nMETHODS\nWe reviewed 25 patients (15 men, 10 women) with acute AC joint separations who were treated with truly anatomic coracoclavicular ligament reconstruction (TACCR) using 2 Endobutton devices between May 2013 and October 2015. Clinical assessments consisted of the visual analog scale (VAS) and the Constant score. Radiologic evaluation was achieved by measuring the coracoclavicular distance (CCD) and acromioclavicular distance (ACD). Previously, this same patient cohort was reviewed after 2 years of follow-up using similar methods.\n\n\nRESULTS\nAll 25 patients were available for mid-term follow-up 5 years after the operation. The mean duration of follow-up was 76 ± 7 months (range, 66-90 months). Twenty-three patients (92%) continued to be very satisfied or satisfied with the treatment results. The VAS and Constant score improved significantly when compared with the baseline (0 ± 0 and 96 ± 3 at 5-year follow-up vs. 5 ± 1 and 45 ± 6 postoperatively) and remained essentially unchanged when compared with the 2-year follow-up data (0 ± 0 and 96 ± 3 at 5-year follow-up vs. 0 ± 1 and 95 ± 3 at 2-year follow-up). Three patients (12%) demonstrated loss of reduction and 5 patients (20%) had calcifications noted at 5-year radiographs. There was, however, no significant difference in clinical outcomes or patient satisfaction when comparing radiographically abnormal patients with anatomically reduced patients.\n\n\nCONCLUSION\nTACCR using 2 Endobutton devices results in satisfactory functional outcomes 5 years postoperatively. In contrast to the baseline, all cases improved significantly.