Risk factors related to loss of reduction after anatomic repair of acromioclavicular joint dislocation in patients with acute traumatic acromioclavicular joint dislocation.

BACKGROUND

Suspension stabilization is a commonly used surgical method for acute acromioclavicular (AC) joint dislocation. However, a failure rate of around 26% caused various emerging surgical techniques and recommendations. We aimed to identify the significance of postulated factors relevant to the radiographic success of AC joint stabilization.

METHODS

The data of patients with acute AC joint dislocation treated with suspension stabilization in our institution from January 2012 to December 2022 were reviewed. Zanca views x-ray films of both AC joints were reviewed including the preoperative, immediate postoperative, and final follow-up film. Failure of stabilization was classified by coracoclavicular distance, AC joint subluxation ratio, and AC joint widening. Factors of interest were age, type of injury classified by Rockwood, K-wire augmentation, over-reduction, clavicular tunnels osteolysis, tunnel position, AC ligament repair, the timing of surgery, and stabilization technique. Univariate and multivariate logistic regression analysis was done for the factors contributing to each failure mode.

RESULTS

There were 57 patients included in the study. Multivariate logistic regression analysis showed that AC ligament repair was significantly related to the success of stabilization using coracoclavicular distance criteria (odd ratio [OR] 0.22, P = .04). Age older than 40 years significantly related to the success of stabilization using AC subluxation ratio and by any type of failure (OR 0.23, P = .02 and OR 0.20, P = .049). Other factors failed to show their significance by any mean of failure criteria.

CONCLUSION

AC ligament repair is related to the success of AC joint stabilization, while additional of K-wire augmentation, direct tunnel position, over-reduction, and earlier surgery could not show their significance in maintaining the reduction.