Saier T, Plath J E, Beitzel K, Minzlaff P, Feucht J M, Reuter S, Martetschläger F, Imhoff Andreas B, Aboalata M, Braun S
Department of Orthopedic Sports Medicine, Technische Universität München, Munich, Germany.
Department of Reconstructive Joint Surgery, Berufsgenossenschaftliche Unfallklinik Murnau, Murnau, Germany.
BMC Musculoskelet Disord. 2016 Apr 2;17:145. doi: 10.1186/s12891-016-0989-8.
To evaluate return-to-activity (RtA) after anatomical reconstruction of acute high-grade acromioclavicular joint (ACJ) separation.
A total of 42 patients with anatomical reconstruction of acute high-grade ACJ-separation (Rockwood Type V) were surveyed to determine RtA at a mean 31 months follow-up (f-u). Sports disciplines, intensity, level of competition, participation in overhead and/or contact sports, as well as activity scales (DASH-Sport-Module, Tegner Activity Scale) were evaluated. Functional outcome evaluation included Constant score and QuickDASH.
All patients (42/42) participated in sporting activities at f-u. Neither participation in overhead/contact sports, nor level of activity declined significantly (n.s.). 62 % (n = 26) of patients reported subjective sports specific ACJ integrity to be at least the same as prior to the trauma. Sporting intensity (hours/week: 7.3 h to 5.4 h, p = .004) and level of competition (p = .02) were reduced. If activity changed, in 50 % other reasons but clinical symptoms/impairment were named for modified behavior. QuickDASH (mean 6, range 0-54, SD 11) and DASH-Sport-Module (mean 6, range 0-56, SD 13) revealed only minor disabilities at f-u. Over time Constant score improved significant to an excellent score (mean 94, range 86-100, SD 4; p < .001). Functional outcome was not correlated with RtA (n.s.).
All patients participated in sporting activities after anatomical reconstruction of high-grade (Rockwood Type V) ACJ-separation. With a high functional outcome there was no significant change in activity level (Tegner) and participation in overhead and/or contact sports observed. There was no correlation between functional outcome and RtA. Limiting, there were alterations in time spent for sporting activities and level of competition observed. But in 50 % those were not related to ACJ symptoms/impairment. Unrelated to successful re-established integrity and function of the ACJ it should be considered that patients decided not return-to-activity but are very content with the procedure.
评估急性重度肩锁关节（ACJ）分离解剖重建后的恢复运动（RtA）情况。
对42例行急性重度ACJ分离（Rockwood V型）解剖重建的患者进行调查，以确定平均随访31个月时的RtA情况。评估运动项目、强度、比赛水平、参与过头和/或接触性运动的情况以及活动量表（DASH运动模块、Tegner活动量表）。功能结局评估包括Constant评分和QuickDASH评分。
所有患者（42/42）在随访时都参与了体育活动。参与过头/接触性运动的情况以及活动水平均无显著下降（无统计学意义）。62%（n = 26）的患者报告主观上特定于运动的ACJ完整性至少与创伤前相同。运动强度（每周小时数：从7.3小时降至5.4小时，p = 0.004）和比赛水平（p = 0.02）有所降低。如果活动发生了变化，50%的患者表示改变行为的原因是其他因素而非临床症状/功能障碍。QuickDASH评分（平均6分，范围0 - 54分，标准差11）和DASH运动模块评分（平均6分，范围0 - 56分，标准差13）显示随访时仅有轻微功能障碍。随着时间推移，Constant评分显著提高至优秀水平（平均94分，范围86 - 100分，标准差4；p < 0.001）。功能结局与RtA无相关性（无统计学意义）。
所有患者在重度（Rockwood V型）ACJ分离解剖重建后都参与了体育活动。尽管功能结局良好，但未观察到活动水平（Tegner量表）以及参与过头和/或接触性运动的情况有显著变化。功能结局与RtA无相关性。局限性在于，观察到体育活动时间和比赛水平有改变。但其中50%与ACJ症状/功能障碍无关。与ACJ成功重建的完整性和功能无关的是，应考虑到患者决定不恢复运动但对手术非常满意。
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