Fixation failure and early loss of reduction with the use of suture anchors for surgical repair of acromioclavicular joint dislocation: a case series.

BACKGROUND

Suture anchors have been used in surgical repair of acromioclavicular joint (ACJ) dislocation. While some reports indicate favorable results, others emphasize less promising outcomes. This case series reports our experience with suture anchors for surgical treatment of ACJ dislocation.

METHODS

Clinical and radiographic outcomes in three patients treated operatively for ACJ dislocations were reviewed. In all patients, two suture anchors were inserted in the coracoid (unicortical) and #5 nonabsorbable suture from the suture anchor was shuttled through drill holes in the clavicle and tied over two button devices. The coracoclavicular ligaments were reconstructed using a figure of eight semitendinosus allograft around the coracoid and clavicle. Postoperatively, sling immobilization was used for 6 weeks, and physical therapy was initiated at 6 weeks with contact activity allowed at 6 months.

RESULTS

Three male patients underwent treatment for Rockwood type 3 (chronic; n = 1) and type 5 (n = 2) ACJ dislocations. Loss of reduction was noted within 6 weeks postoperatively. Two patients exhibited failure due to complete suture anchor pullout and the third patient had partial pull out of one of the anchors. Additionally, the third patient also suffered a coracoid fracture adjacent to the anchor's placement after sustaining direct trauma to his shoulder, one-year postoperatively.

CONCLUSION

In our case series, we found a high rate of fixation failure and early loss of reduction with the use of suture anchors for the treatment of ACJ dislocation. These findings should be taken into consideration when selecting an appropriate implant for fixation of ACJ dislocation.