Reconstruction of Acute Acromioclavicular (AC) Joint Dislocations with or without Tendon Graft: a Retrospective Comparative Study



1 Kerlan-Jobe Orthopaedic Clinic

2 Rothman Institute, Thomas Jefferson University, USA


Background: Reconstructions of acute acromioclavicular (AC) dislocations have been thought to result in superior
outcomes than chronic dislocations. The use of tendon graft in reconstructions has demonstrated favorable
biomechanical properties. To determine whether utilizing tendon graft during repair of acute AC dislocations results in
superior outcomes and lower complication rate.
Methods: A retrospective review of AC reconstructions was conducted. Reconstructions performed within 3 weeks of
injury were included. Inclusion criteria included age over 18, grade 3-5 AC joint separation, and no previous ipsilateral
shoulder injury. Primary outcome measure was radiographic loss of reduction. Secondary outcomes included ASES
and SANE scores.
Results: Of 47 reconstructions of acute AC joint separations, 35 utilized fixation without a tendon graft, while 12
underwent an anatomic reconstruction with tendon graft. Repairs without the use of graft resulted in 8 (23%) cases
of loss of reduction, while tendon graft augmented repairs resulted in 5 (42%). This difference was not statistically
significant (P = 0.22). No patients required reoperation. There was no statistical difference in the ASES and SANE
scores between the two groups. Furthermore, we found no significant difference in ASES or SANE scores in patients
who maintained reduction postoperatively versus those that lost reduction.
Conclusion: A greater but not statistically significant rate of loss of reduction was observed in the group reconstructed
with the use of a tendon graft. Further research is needed to determine whether the use of tendon graft is beneficial in
the treatment of acute AC joint separations.
Level of evidence: IV


Main Subjects