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Clinical Outcomes of a Novel Single-Tunnel Technique for Coracoclavicular and Acromioclavicular Ligament Reconstruction
ESSKA Academy. vanEck C. 05/09/18; 209896; P21-781 Topic: Sports Related Injuries
Carola vanEck
Carola vanEck
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Abstract
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Objectives: A large number of surgical techniques have been described to treat acromioclavicular (AC) joint separations. Despite the high success rates with double-tunnel anatomic AC joint reconstruction, this method has been associated with the risk of coracoid and clavicle fracture. This study aimed to evaluate the 2 year outcomes of the first cohort of patients who underwent a novel single-tunnel AC and coracoclavicular (CC) ligament reconstruction technique. It was hypothesized that this technique would result in maintenance of reduction and a minimal risk of fracture of the coracoid and clavicle with good patient reported outcomes scores.

Methods: Level IV Case Series. All patients who underwent single-tunnel AC joint reconstruction between 2012 and 2015 using the technique were included. Outcomes recorded were maintenance of reduction on visual inspection and radiographs, shoulder range of motion, strength, complications, return to sports and various patient reported outcomes. The difference between pre- and post-operative radiographic measurements and patient reported outcomes was calculated using the paired t-test for the continuous variables and the Fisher's exact test for the nominal variables.

Results: Seventeen patients were included with a mean age of 41 ± 12 years. Separation types included types III, IV and V. CC distance improved from 37.4 to 30.0 (p = 0.006), American Shoulder and Elbow Society (ASES) score from 67.0 to 90.1 (p = 0.094), and Single Assessment Numeric Evaluation (SANE) from 30.5 to 91.1 (p = 0.025). Reduction was maintained in 16 patients (94.1%). Fourteen patients (82.4%) returned to their preinjury level of sports participation. The most common complication was a prominent suture stack in 3 patients (17.6%). There were no clavicle or coracoid fractures.

Conclusions: The described technique results in satisfactory objective and patient reported outcomes and return to sports at 2 year follow-up while avoiding coracoid and clavicle fractures.

Keywords:
acromioclavicular; coracoclavicular; single-tunnel; reconstruction; outcomes
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