title: Associated lesions requiring additional surgical treatment in grade 3 acromioclavicular joint dislocations.
abstract: OBJECTIVE
  To evaluate the incidence of associated pathologic shoulder lesions that were addressed surgically in grade 3 acromioclavicular joint (ACJ) dislocations, as well as to compare this incidence between younger and older patients and between acute and chronic cases.
  
  
  METHODS
  In this multicenter nonrandomized retrospective study, 98 patients operated on for grade 3 ACJ dislocation underwent concomitant arthroscopic evaluation for the identification and treatment of any associated lesions. The type and treatment of associated lesions were collected in a central database and analyzed. We classified patients according to age (<45 years and ≥ 45 years) and according to the length of time between trauma and surgical treatment (≤ 30 days and ≥ 120 days), obtaining the following stratification: younger acute, older acute, younger chronic, and older chronic.
  
  
  RESULTS
  Of the patients, 42 (42.8%) were diagnosed with at least 1 additional pathologic lesion, and 29 (29.5%) required a dedicated additional treatment. Rates of treatment on associated lesions were analyzed: younger versus older groups presented a significant difference, as did younger acute versus older acute groups; SLAP and posterior rotator cuff tear treatments represented 24 of the 35 additional surgeries (68.5%).
  
  
  CONCLUSIONS
  The overall rate of associated pathologic lesions requiring additional surgical treatment in patients with ACJ dislocation was 29.5%. Patients aged 45 years or older had a greater risk of presenting with associated lesions that needed to be surgically addressed (odds ratio, 3.01). The overall rates of associated surgical lesions in acute versus chronic cases were not shown to be significantly different.
  
  
  METHODS
  Level IV, prognostic case series.
authors.affiliation: The Burkhart's Research Association of Shoulder Specialists (BRASS) Group, San Antonio, Texas, U.S.A; and Università degli Studi di Milano (L.Z.), Milan, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Arrigoni
authors.affiliation: The Burkhart's Research Association of Shoulder Specialists (BRASS) Group, San Antonio, Texas, U.S.A; and Università degli Studi di Milano (L.Z.), Milan, Italy.
authors.forename: Paul C
authors.initials: PC
authors.lastname: Brady
authors.affiliation: The Burkhart's Research Association of Shoulder Specialists (BRASS) Group, San Antonio, Texas, U.S.A; and Università degli Studi di Milano (L.Z.), Milan, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Zottarelli
authors.affiliation: The Burkhart's Research Association of Shoulder Specialists (BRASS) Group, San Antonio, Texas, U.S.A; and Università degli Studi di Milano (L.Z.), Milan, Italy.
authors.forename: Johannes
authors.initials: J
authors.lastname: Barth
authors.affiliation: The Burkhart's Research Association of Shoulder Specialists (BRASS) Group, San Antonio, Texas, U.S.A; and Università degli Studi di Milano (L.Z.), Milan, Italy.
authors.forename: Pablo
authors.initials: P
authors.lastname: Narbona
authors.affiliation: The Burkhart's Research Association of Shoulder Specialists (BRASS) Group, San Antonio, Texas, U.S.A; and Università degli Studi di Milano (L.Z.), Milan, Italy.
authors.forename: David
authors.initials: D
authors.lastname: Huberty
authors.affiliation: The Burkhart's Research Association of Shoulder Specialists (BRASS) Group, San Antonio, Texas, U.S.A; and Università degli Studi di Milano (L.Z.), Milan, Italy.
authors.forename: Samuel S
authors.initials: SS
authors.lastname: Koo
authors.affiliation: The Burkhart's Research Association of Shoulder Specialists (BRASS) Group, San Antonio, Texas, U.S.A; and Università degli Studi di Milano (L.Z.), Milan, Italy.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Adams
authors.affiliation: The Burkhart's Research Association of Shoulder Specialists (BRASS) Group, San Antonio, Texas, U.S.A; and Università degli Studi di Milano (L.Z.), Milan, Italy.
authors.forename: Peter
authors.initials: P
authors.lastname: Parten
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Denard
authors.affiliation: The Burkhart's Research Association of Shoulder Specialists (BRASS) Group, San Antonio, Texas, U.S.A; and Università degli Studi di Milano (L.Z.), Milan, Italy.
authors.forename: Patrick
authors.initials: P
authors.lastname: Denard
authors.affiliation: The Burkhart's Research Association of Shoulder Specialists (BRASS) Group, San Antonio, Texas, U.S.A; and Università degli Studi di Milano (L.Z.), Milan, Italy. Electronic address: gruelas@tsaog.com.
authors.forename: Stephen S
authors.initials: SS
authors.lastname: Burkhart
mesh_terms: D000173:Acromioclavicular Joint / Q000293:injuries*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001134:Arm Injuries / Q000453:epidemiology / Q000601:surgery; D001182:Arthroscopy; D002908:Chronic Disease; D015897:Comorbidity; D005260:Female; D006801:Humans; D058430:Humeral Head / Q000293:injuries* / Q000601:surgery; D015994:Incidence; D007593:Joint Instability / Q000453:epidemiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D017006:Rotator Cuff / Q000601:surgery; D000070636:Rotator Cuff Injuries; D012783:Shoulder Dislocation / Q000453:epidemiology* / Q000601:surgery*; D013708:Tendon Injuries / Q000453:epidemiology / Q000601:surgery; D055815:Young Adult