Acromion Clavicular Joint Reconstruction with LARS Ligament in Acute Dislocation



1 Orthopedic Department, San Giacomo Apostolo Hospital, Castelfranco Veneto, Italy

2 Veneto Institute of Oncology IOV - IRCCS, Padua, Italy

3 Department of Orthopedic Surgery, University of Palermo (DiChirOnS), Palermo, Italy


Background: The acromion clavicular joint dislocations are common injuries of the shoulder. The severity is dependent
upon the degree of ligamentous injury. Surgical treatment is typically performed in higher grade acromioclavicular
separation with several static and dynamic operative procedures with or without primary ligament replacement.
Methods: 47 patients with acute Rockwood type III, IV, and V injuries were treated surgically with LARS reconstruction.
The success of technique was evaluated by radiographic outcomes for each patient at every follow-up visit (one,
three, 12 months), while to assess pain reduction and clinical evaluation Visual Analogue scale score (VAS) and
Constant-Murley score (CMA) was performed, respectively. An One Way Analysis of Variance (Kruskal-Wallis test), a
multiple comparison Turket test, or a t-test (Mann-Whitney Rank Sum Test) were used when required.
Results: Follow-up radiographs revealed maintenance of anatomical reduction in 41 patients, and no bone erosions
has been identified. In short-term joint functional recovery has been observed. Indeed, after 12 months pain on the
VAS-scale in all groups decreased significantly (P < 0.05), and the CMS revealed a significant overall improvement
(P < 0.05).
Conclusion: These data demonstrate that the use of the LARS allows to provide stability to the joint and especially to
ensure its natural elasticity, relieving pain and improving joint function already one month post-surgery.
Level of evidence: III


Main Subjects