Department of Orthopaedics and Traumatology, San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy.
Injury. 2010 Nov;41(11):1103-6. doi: 10.1016/j.injury.2010.09.023. Epub 2010 Oct 8.
Surgical treatment of chronic complete acromioclavicular (AC) joint dislocation is still debated and no gold standard surgical procedure has been identified.
A retrospective series of 90 patients treated for AC dislocations is reported here. Patients were divided into three groups: group 1 receiving AC reconstruction with a Dacron vascular prosthesis; group 2 receiving AC reconstruction with LARS(®) artificial ligament; group 3 receiving conservative treatment. Follow-up was performed after 1, 6 and 15 months with plain radiographs, UCLA, SPADI and modified UCLA acromioclavicular rating scales.
Patients treated surgically presented significant better functional outcome compared to patients treated conservatively with overall positive results in 93.3% of patients for group 2 and 53.3% of patients for group 1. However, reconstruction with Dacron vascular prosthesis presented an unacceptable high complications rate (43.3%).
Our results show that anatomic AC reconstruction with LARS(®) artificial ligament resulted in both satisfactory functional outcome and low complication rate. Therefore, we recommend this procedure for the treatment of chronic complete AC dislocations.
慢性完全性肩锁关节(AC)脱位的手术治疗仍存在争议,尚无金标准的手术方法。
本研究报道了一组 90 例接受 AC 脱位治疗的回顾性系列病例。患者分为三组:组 1 接受涤纶血管假体 AC 重建;组 2 接受 LARS(®)人工韧带 AC 重建;组 3 接受保守治疗。术后 1、6 和 15 个月进行常规 X 线、UCLA、SPADI 和改良 UCLA 肩锁关节评分评估。
与保守治疗相比,手术治疗的患者功能恢复明显更好,组 2 患者总体结果为 93.3%,组 1 患者总体结果为 53.3%。然而,涤纶血管假体重建的并发症发生率较高(43.3%)。
我们的结果表明,LARS(®)人工韧带的解剖 AC 重建可获得满意的功能结果和低并发症发生率。因此,我们推荐该手术方法治疗慢性完全性 AC 脱位。