title: Modified Weaver-Dunn procedure versus the use of a synthetic ligament for acromioclavicular joint reconstruction.
abstract: PURPOSE. To compare the subjective outcome of acromioclavicular joint (ACJ) reconstruction using the modified Weaver-Dunn procedure versus the Surgilig synthetic ligament. METHODS. 55 patients aged 19 to 72 (mean, 42) years underwent ACJ reconstruction of Rockwood grade 3 (n=38), grade 4 (n=8), and grade 5 (n=9) using the modified Weaver-Dunn procedure (n=31) or the Surgilig synthetic ligament (n=24), based on the surgeon's preference. The mean period from injury to surgical treatment was 39 months. Subjective outcomes were assessed before and after surgery using the Oxford Shoulder score and Nottingham Clavicle score. The time required to return to work and sports was also recorded. RESULTS. After a mean follow-up period of 40 months, the mean Oxford Shoulder scores improved from 28 to 42 in the Weaver-Dunn group (p=0.009), and from 26 to 45 in the Surgilig group (p=0.007), whereas the respective mean Nottingham Clavicle scores improved from 53 to 81 (p=0.047) and from 51 to 93 (p=0.023). The Surgilig group achieved significantly better postoperative Oxford Shoulder score (p=0.008) and Nottingham Clavicle score (p=0.007), and could also return to work (14 vs. 6 weeks, p<0.001) and sports (25 vs. 12 weeks, p<0.001) sooner than the Weaver-Dunn group. Three patients in the Weaver- Dunn group and one patient in the Surgilig group had persistent pain and/or functional deficit with evidence of ACJ dislocation. CONCLUSION. Chronic ACJ reconstruction using the Surgilig synthetic ligament achieved better Oxford Shoulder score and Nottingham Clavicle score and earlier return to work and sports, compared with the modified Weaver-Dunn procedure.
authors.affiliation: Nottingham Shoulder and Elbow Unit, Nottingham University Hospitals NHS Trust, United Kingdom.
authors.forename: Vinod
authors.initials: V
authors.lastname: Kumar
authors.forename: Sunil
authors.initials: S
authors.lastname: Garg
authors.forename: IhabI
authors.initials: I
authors.lastname: Elzein
authors.forename: Tom
authors.initials: T
authors.lastname: Lawrence
authors.forename: Paul
authors.initials: P
authors.lastname: Manning
authors.forename: W Angus
authors.initials: WA
authors.lastname: Wallace
mesh_terms: D000173:Acromioclavicular Joint / Q000293:injuries*; D000328:Adult; D000368:Aged; D001178:Arthroplasty / Q000295:instrumentation*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016268:Internal Fixators; D004204:Joint Dislocations / Q000601:surgery*; D008023:Ligaments, Articular / Q000637:transplantation*; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: acromioclavicular joint; dislocations; reconstructive surgical procedures