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

Marcheggiani Muccioli, GM; Manning, C; Wright, P; Grassi, A; Zaffagnini, S; Funk, L

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.

Citation

Marcheggiani Muccioli, G., Manning, C., Wright, P., Grassi, A., Zaffagnini, S., & Funk, L. (2016). Acromioclavicular joint reconstruction with the LARS ligament in professional versus non-professional athletes. Knee Surgery, Sports Traumatology, Arthroscopy, 24(6), 1961-1967. https://doi.org/10.1007/s00167-014-3231-y

• Journal Article Type: Article
• Publication Date: Jan 1, 2016
• Deposit Date: Nov 7, 2016
• Journal: Knee Surgery, Sports Traumatology, Arthroscopy
• Print ISSN: 0942-2056
• Publisher: Springer Verlag
• Volume: 24
• Issue: 6
• Pages: 1961-1967
• DOI: https://doi.org/10.1007/s00167-014-3231-y
• Publisher URL: http://dx.doi.org/10.1007/s00167-014-3231-y