Arthroscopic Coracoclavicular Ligament Reconstruction With Double-Bundle Soft Tissue Allograft for Chronic Type V Acromioclavicular Dislocations Shows Excellent Patient Outcomes and Return to Duty and Sport at Minimum 10-Year Follow-Up.

PURPOSE

To report long-term outcomes at over a 10-year follow-up after arthroscopic coracoclavicular (CC) ligament reconstruction using a double-bundle soft tissue allograft coracoid cerclage technique for chronic (>4 weeks), high-grade (type V) acromioclavicular (AC) dislocations in an active-duty military population.

METHODS

Patients undergoing arthroscopic CC ligament reconstruction for chronic type V AC dislocations between March 2011 and December 2013 with a minimum 10-year follow-up (range, 10-12.8 years) were eligible for inclusion in this retrospective case series. Outcomes measures included the pain visual analog scale; Single Assessment Numeric Evaluation; Constant score; American Shoulder and Elbow Surgeons score; Simple Shoulder Test; range of motion, including forward flexion, external rotation, and internal rotation; and rates of return to active duty and sports participation.

RESULTS

Overall, 19 patients (average age of 26.1 ± 6.7 years, 100% male) met inclusion criteria. The mean follow-up was 134.2 ± 10.4 months. All patients had a profound decrease in pain, as measured by the pain visual analog scale, and a marked, sustained improvement in functional outcomes at final follow-up, as determined by the Single Assessment Numeric Evaluation, Constant score, Simple Shoulder Test, and American Shoulder and Elbow Surgeons scores (P < .0001 for all). There were no statistically significant differences between preoperative and postoperative range of motion (forward flexion, P = .3382; external rotation, P = .2350; internal rotation, P = .2590). Overall, 94.7% (n = 18/19) of patients were able to remain on active duty, and 89.5% (n = 17/19) of patients returned to sport, of whom 94.1% (n = 16/17) were able to return to sport at prior levels. One patient experienced superficial wound infection, 1 developed AC osteoarthritis, and 1 progressed to asymptomatic loss of reduction.

CONCLUSIONS

Outcomes after arthroscopic CC reconstruction for chronic type V AC dislocations in an active-duty military patient population show sustained and statistically significant improvements in functional outcomes as well as high rates of return to sport and active duty.

LEVEL OF EVIDENCE

Level IV, retrospective case series.