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

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

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.

Publication types

  • Comparative Study

MeSH terms

  • Acromioclavicular Joint / injuries
  • Acromioclavicular Joint / surgery*
  • Adult
  • Athletic Injuries / surgery
  • Female
  • Humans
  • Ligaments, Articular / surgery*
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Prospective Studies
  • Prostheses and Implants*
  • Return to Sport
  • Shoulder Dislocation / surgery*
  • Suture Techniques
  • Young Adult