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Knee Surg Sports Traumatol Arthrosc. 2016 Jun;24(6):1961-7. doi: 10.1007/s00167-014-3231-y. Epub 2014 Aug 23.

Acromioclavicular joint reconstruction with the LARS ligament in professional versus non-professional athletes.

Author information

1
Laboratorio di Biomeccanica - Istituto Ortopedico Rizzoli, University of Bologna, via di Barbiano, 1/10, 40100, Bologna, Italy. marcheggianimuccioli@me.com.
2
Manchester University, Manchester, UK.
3
Wrightington Hospital, Wigan, UK.
4
Laboratorio di Biomeccanica - Istituto Ortopedico Rizzoli, University of Bologna, via di Barbiano, 1/10, 40100, Bologna, Italy.
5
Salford University, Manchester, UK.

Abstract

PURPOSE:

To compare outcomes of acromioclavicular (AC) joint reconstruction with ligament augmentation and reconstruction system (LARS) ligament in professional and non-professional athletes at 2-year minimum follow-up.

METHODS:

Forty-three patients (men; mean age 30, range 19-54 years) with Rockwood type III to V chronic AC joint dislocations underwent AC joint reconstruction with LARS ligament and standardized rehabilitation. Patients were divided into two groups: professionals (22) and non-professionals (21). Clinical and radiological evaluations were performed preoperatively, at 3- and 24-month follow-up.

RESULTS:

All clinical (Oxford and Constant) scores and patient satisfaction improved significantly from preoperative to follow-up intervals (p < 0.00001). However, professionals showed nonsignificant improvements from 3- to 24-month follow-up in Constant. Although groups differed preoperatively in Constant (p = 0.037), they were not different in preoperative-to-postoperative differences in clinical scores, postoperative final satisfaction and median time to return to unrestricted activity [4 (interquartiler range 3-5) months to return to full sport in professionals]. Follow-up radiographs revealed an AC joint ratio (clavicle inferior-to-superior translation as ratio of AC joint height) of 0.09 and 0.16 in 8/22 professionals, 0.19 and 0.31 in 9/21 non-professionals, 0.14 and 0.24 in 17/43 overall patients at 3- and 24-month follow-up, respectively. Slight loss of reduction (0.25 < AC joint ratio < 0.50): 21 %. There were no significant clinical-radiographic correlations. Complication: one coracoid fracture at follow-up and one wound infection.

CONCLUSIONS:

AC joint reconstruction with LARS ligament did not reveal differences in clinical outcomes between groups, with 2 % of failures (re-dislocations) at 2-year minimum follow-up. Superior radiological outcomes in professionals were not correlated to clinical results.

LEVEL OF EVIDENCE:

Therapeutic study-prospective comparative study, Level II.

KEYWORDS:

Acromioclavicular joint; Dislocation; LARS artificial ligament; Reconstruction

PMID:
25149645
DOI:
10.1007/s00167-014-3231-y
[Indexed for MEDLINE]

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