Comparison of Functional and Radiological Results in Patients with Grade V Acromioclavicular Dislocation: Overcorrection Versus Conventional Correction with Arthroscopic Stabilization
DOI:
https://doi.org/10.63403/re.v32i1.385Keywords:
Acromioclavicular Joint Injury, Coracoclavicular Joint Stabilization, OverreductionAbstract
Introduction: There are reports indicating that over-correction of the Acromioclavicular (AC) joint in the treatment of acute dislocations leads to better radiological and clinical results than anatomical or insufficient reduction.
Objectives: To analyze the radiological and functional outcomes of a series of patients who underwent arthroscopically assisted stabilization with capsular repair for acute grade V AC joint dislocations. The results between patients with and without overcorrection of the AC joint were compared.
Methods: In this retrospective study, patients treated with AC overcorrection (Group 1) were compared to patients without AC overcorrection (Group 2). At 2 years follow-up, functional results were evaluated by SSV, ACJI, Constant and ASES scores. Radiological AC alignment in the vertical and horizontal plane were analyzed. Return to sports and postoperative complications were reported.
Results: Twenty-three patients were analyzed, 11 patients in Group 1 and 12 patients in Group 2. The average age was 33 ± 8 years.
In group 1 the mean CC distance was 4.2 ± 0.4 in the immediate postoperative period and 10.8 ± 3 at the end of follow-up. Four patients presented partial or complete loss of reduction at the end of follow-up (36.4%). No patient remained overcorrected over time. In Group 2 the mean CC distance was 8.9 ± 2 in the immediate postoperative period and 13.1 ± 4.8 at the end of follow-up. Six patients presented partial or complete loss of reduction at the end of follow-up (50%).
In Group 1, five patients (45.5%) presented partial or complete loss of horizontal reduction, while in Group 2, six patients (50%) presented partial or complete loss in the horizontal plane. Both groups presented significant improvement in functional scores and range of motion (ROM), with no differences between groups. Ninety one percent of patients returned to sports in 5.5 ± 2 months. The complication rate was 9%.
Conclusion: In grade V AC joint dislocations, overcorrection of the AC distance leads to better radiological outcomes. Loss of reduction was high in both groups without affecting functional results or return to sports.
Level of evidence: III. Retrospective comparative study
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