Reconstruction of Acromioclavicular Joint Dislocation with Hamstrings Autograft
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- Category: Vol. 84, September 2016
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Reconstruction of Acromioclavicular Joint Dislocation with Hamstrings Autograft, KHALED SHOHAYEB, AHMED R. MOHAMMED, WALEED REDA, HAZEM MAHMOUD and AHMAD ABU ELFADL
Abstract
Background: The aim of the current study is to evaluate the technique of reconstruction of Acromioclavicular (AC) joint dislocation using tendon autograft (semitendinosus) and to assess clinical, radiographic results and complications associated with this procedure.
Methods: This is a prospective study was conducted on 20 patients with 20 dislocations from May 2013 till March 2014 including patients with Acromioclavicular joint disloca-tion (AC joint) presenting to Kasr Al-Ainy Hospital (Level I Trauma Centre) treated by reconstruction with Semitendi-nosus autograft, 16 patients were followed-up with mean age was 32.4±9.3 years and mean follow-up duration was 6.8 month, 4 patients lost in follow-up.
Results: 20 patients with twenty AC joint dislocations were included in this study, 16 patients were followed-up and 4 patients were lost in follow-up. We followed the patients for postoperative pain, activity level, arm positioning, and strength of abduction in pounds, range of motion. Preoperative 2 patients had sever pain 13 moderate and 1 mild, postoperative 6 patients had no pain, 10 patients had mild pain, preoperative
1 patient had unaffected sleep and 15 were affected, postop-erative 11 patients had unaffected sleep and 5 patients had affected sleep. Preoperative 2 patients could engage in recre-ational sports and 14 couldn't, postoperative 11 could and 5 couldn't, 14 patients couldn't return to work preoperative and
2 could, postoperative 12 could return to work and 4 couldn't. Preoperative strength of abduction was 19-21 pounds in 6 patients, 15-18 in 8 and 13-15 in 2 patients, postoperative 12 patients had >24 pounds and 4 patients had 22-24 pounds. Constant score was poor for the 16 patients preoperative and excellent for 11, good for 3, fair for 1 and poor for 1 patient postoperative.
By X-ray 14 patients had complete reduction, 2 patients had subluxation <25% immediate postoperative while 10 patients had complete reduction at last follow-up and 6 patients had >25% subluxation.
Conclusion: The results of coracoclavicular reconstruction using semitendinosus graft have been very promising, safe and feasible surgical technique to treat acute and chronic acromioclavicular joint dislocation. However, the patient should be compliant to the rehabilitation protocol to ensure an optimal outcome of the reconstructive procedure.
Level of Evidence: Level IV case series study.