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BMC Musculoskelet Disord. 2016 Apr 2;17:145. doi: 10.1186/s12891-016-0989-8.

Return-to-activity after anatomical reconstruction of acute high-grade acromioclavicular separation.

Author information

1
Department of Orthopedic Sports Medicine, Technische Universität München, Munich, Germany.
2
Department of Reconstructive Joint Surgery, Berufsgenossenschaftliche Unfallklinik Murnau, Murnau, Germany.
3
Chirurgische Klinik Dr. Rinecker, Munich, Germany.
4
Department Orthopedics and Traumatology University of Freiburg, Freiburg, Germany.
5
Center for Shoulder and Elbow Surgery, ATOS Clinic Munich, Munich, Germany.
6
Department of Orthopedic Sports Medicine, Technische Universität München, Munich, Germany. a.imhoff@sportortho.de.
7
Department of Orthopaedic Surgery, Mansoura University, Mansoura, Egypt.

Abstract

BACKGROUND:

To evaluate return-to-activity (RtA) after anatomical reconstruction of acute high-grade acromioclavicular joint (ACJ) separation.

METHODS:

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.

RESULTS:

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.).

CONCLUSION:

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.

KEYWORDS:

Acromioclavicular; Acromioclavicular separation; Arthroscopy; Reconstruction; Return-to-activity; Returnto-sports; Rockwood V; Tight-rope; suture button device

PMID:
27039293
PMCID:
PMC4818932
DOI:
10.1186/s12891-016-0989-8
[Indexed for MEDLINE]
Free PMC Article

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