Arthroscopic Coracoclavicular Ligament Reconstruction With Double-Bundle Soft Tissue Allograft for Chronic Type V Acromioclavicular Dislocations Shows Excellent Patient Outcomes and Return to Duty and Sport at Minimum 10-Year Follow-Up.

PURPOSE: To report long-term outcomes at over a 10-year follow-up after arthroscopic coracoclavicular (CC) ligament reconstruction using a double-bundle soft tissue allograft coracoid cerclage technique for chronic (>4 weeks), high-grade (type V) acromioclavicular (AC) dislocations in an active-duty military population.

METHODS

Patients undergoing arthroscopic CC ligament reconstruction for chronic type V AC dislocations between March 2011 and December 2013 with a minimum 10-year follow-up (range, 10-12.8 years) were eligible for inclusion in this retrospective case series. Outcomes measures included the pain visual analog scale; Single Assessment Numeric Evaluation; Constant score; American Shoulder and Elbow Surgeons score; Simple Shoulder Test; range of motion, including forward flexion, external rotation, and internal rotation; and rates of return to active duty and sports participation.

RESULTS

Overall, 19 patients (average age of 26.1 ± 6.7 years, 100% male) met inclusion criteria. The mean follow-up was 134.2 ± 10.4 months. All patients had a profound decrease in pain, as measured by the pain visual analog scale, and a marked, sustained improvement in functional outcomes at final follow-up, as determined by the Single Assessment Numeric Evaluation, Constant score, Simple Shoulder Test, and American Shoulder and Elbow Surgeons scores (P < .0001 for all). There were no statistically significant differences between preoperative and postoperative range of motion (forward flexion, P = .3382; external rotation, P = .2350; internal rotation, P = .2590). Overall, 94.7% (n = 18/19) of patients were able to remain on active duty, and 89.5% (n = 17/19) of patients returned to sport, of whom 94.1% (n = 16/17) were able to return to sport at prior levels. One patient experienced superficial wound infection, 1 developed AC osteoarthritis, and 1 progressed to asymptomatic loss of reduction.

CONCLUSIONS

Outcomes after arthroscopic CC reconstruction for chronic type V AC dislocations in an active-duty military patient population show sustained and statistically significant improvements in functional outcomes as well as high rates of return to sport and active duty.

LEVEL OF EVIDENCE: Level IV, retrospective case series.