title: Surgical treatment of chronic acromioclavicular joint dislocation with autogenous tendon grafts.
abstract: BACKGROUND
  Conservative treatment of acromioclavicular (AC) joint dislocation is not always successful. A consequence of persistent AC joint dislocation may be chronic pain and discomfort in the shoulder region as well a sensation of constant AC joint instability and impaired shoulder function. Stabilization of the AC joint may reduce these sequels.
  
  
  METHODS
  Due to chronic AC joint dislocation, 39 patients in our hospital underwent coracoclavicular (CC) ligament reconstruction with autogenous semitendinosus and gracilis tendons between May 2005 and April 2011. We examined 25 patients after a mean of 4.2 years. The outcomes were Constant shoulder Score (CS), Disabilities of the Arm, Shoulder and Hand (DASH), pain (Visual Analog Scale, VAS), cross-arm test, stability of the AC joint, and complications. The follow-up visits included anteroposterior and axillary radiographs.
  
  
  RESULTS
  Mean CS was 83 in the injured shoulder and 91 in the uninjured shoulder (p = 0.002). Mean DASH was 14. In 14 patients, the AC joint was clinically stable; pain was minor. In radiographs, osteolysis of the lateral clavicle and tunnel widening were markedly common. Fracture of the coracoid process occurred in 5 patients, and 3 suffered a fracture of the clavicle; 2 had a postoperative infection.
  
  
  CONCLUSIONS
  Anatomic reconstruction of CC ligaments showed a moderate subjective outcome at the 4-year follow-up. After surgery, almost half the AC joints failed to stabilize. Lateral clavicle osteolysis and tunnel widening were notably common complications.
authors.affiliation: Department of Surgery, Helsinki University Central Hospital and University of Helsinki, Topeliuksenkatu 5, Helsinki, 00260 Finland.
authors.forename: Kaisa J
authors.initials: KJ
authors.lastname: Virtanen
authors.affiliation: Department of Surgery, Helsinki University Central Hospital and University of Helsinki, Topeliuksenkatu 5, Helsinki, 00260 Finland.
authors.forename: Vesa
authors.initials: V
authors.lastname: Savolainen
authors.affiliation: Department of Surgery, Helsinki University Central Hospital and University of Helsinki, Topeliuksenkatu 5, Helsinki, 00260 Finland.
authors.forename: Ilkka
authors.initials: I
authors.lastname: Tulikoura
authors.affiliation: Department of Surgery, Helsinki University Central Hospital and University of Helsinki, Topeliuksenkatu 5, Helsinki, 00260 Finland.
authors.forename: Ville
authors.initials: V
authors.lastname: Remes
authors.affiliation: Department of Radiology, Helsinki Medical Imaging Centre, Helsinki University Central Hospital, Topeliuksenkatu 5, Helsinki, 00260 Finland.
authors.forename: Ville
authors.initials: V
authors.lastname: Haapamäki
authors.affiliation: Department of Surgery, Helsinki University Central Hospital and University of Helsinki, Topeliuksenkatu 5, Helsinki, 00260 Finland.
authors.forename: Jarkko
authors.initials: J
authors.lastname: Pajarinen
authors.affiliation: Department of Surgery, Helsinki University Central Hospital and University of Helsinki, Topeliuksenkatu 5, Helsinki, 00260 Finland.
authors.forename: Jan-Magnus
authors.initials: JM
authors.lastname: Björkenheim
authors.affiliation: Department of Surgery, Helsinki University Central Hospital and University of Helsinki, Topeliuksenkatu 5, Helsinki, 00260 Finland ; Centre for Health and Social Economics, Institute for Health and Welfare, PL 30, Helsinki, 00271 Finland.
authors.forename: Mika
authors.initials: M
authors.lastname: Paavola
keywords: Chronic acromioclavicular joint dislocation; Delayed surgical treatment; Tendon graft