title: Prevalence of concomitant intraarticular lesions in patients treated operatively for high-grade acromioclavicular joint separations.
abstract: The purpose of this study is to investigate the prevalence of concomitant intraarticular lesions to the glenohumeral joint or to surrounding soft tissue structures with non-randomized prospective case series. High-grade acromioclavicular (AC) joint dislocations result from direct or indirect force impact to the shoulder girdle. Fourty consecutive patients (2 female, 38 male) with high-grade acromioclavicular joint dislocations (Rockwood III: n = 3; IV: n = 3; V: n = 34) who underwent diagnostic arthroscopy at the time of acromioclavicular joint repair were evaluated. Associated pathologic lesions were documented and treated by an all-arthroscopic approach. As a result, traumatic intraarticular lesions were found in 15% (n = 6/40) of cases. Two patients had an isolated partial tear of the subscapularis tendon. One patient had a combined tear of the subscapularis and supraspinatus tendon (PASTA type lesion). Two patients showed a type II SLAP-lesion and one patient had a type VI SLAP-lesion. Arthroscopic treatment included rotator cuff reconstruction in two cases and debridement of the partially torn tendon in one case. Two patients underwent an arthroscopic SLAP-repair and in one patient a debridement of a labral flap tear was performed. Acromioclavicular joint reconstruction was achieved via an open technique using suture anchors in 14 cases and via an all-arthroscopic approach using a double Tight-rope technique in 26 cases. To conclude, in number of cases, high-grade AC-separations may be associated with traumatic concomitant glenohumeral pathologies resulting from the same trauma impact to the shoulder girdle. A combined or an all-arthroscopic approach allows to accurately diagnose and treat associated intraarticular pathologies.
authors.affiliation: Center for Musculoskeletal Surgery, Charité-Universitaetsmedizin Berlin, Berlin, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Pauly
authors.forename: Christian
authors.initials: C
authors.lastname: Gerhardt
authors.forename: Norbert P
authors.initials: NP
authors.lastname: Haas
authors.forename: Markus
authors.initials: M
authors.lastname: Scheibel
mesh_terms: D000173:Acromioclavicular Joint / Q000293:injuries* / Q000601:surgery; D000328:Adult; D001182:Arthroscopy / Q000379:methods; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D008297:Male; D009104:Multiple Trauma / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery; D015995:Prevalence; D011446:Prospective Studies; D000070636:Rotator Cuff Injuries; D000070599:Shoulder Injuries; D055815:Young Adult