title: Acromioclavicular joint reconstruction with the LARS ligament in professional versus non-professional athletes.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Therapeutic study-prospective comparative study, Level II.
authors.affiliation: Laboratorio di Biomeccanica - Istituto Ortopedico Rizzoli, University of Bologna, via di Barbiano, 1/10, 40100, Bologna, Italy. marcheggianimuccioli@me.com.
authors.forename: Giulio Maria
authors.initials: GM
authors.lastname: Marcheggiani Muccioli
authors.affiliation: Manchester University, Manchester, UK.
authors.forename: Christopher
authors.initials: C
authors.lastname: Manning
authors.affiliation: Wrightington Hospital, Wigan, UK.
authors.forename: Philip
authors.initials: P
authors.lastname: Wright
authors.affiliation: Laboratorio di Biomeccanica - Istituto Ortopedico Rizzoli, University of Bologna, via di Barbiano, 1/10, 40100, Bologna, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Grassi
authors.affiliation: Laboratorio di Biomeccanica - Istituto Ortopedico Rizzoli, University of Bologna, via di Barbiano, 1/10, 40100, Bologna, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Zaffagnini
authors.affiliation: Wrightington Hospital, Wigan, UK.|Salford University, Manchester, UK.
authors.forename: Lennard
authors.initials: L
authors.lastname: Funk
mesh_terms: D000173:Acromioclavicular Joint / Q000293:injuries / Q000601:surgery*; D000328:Adult; D001265:Athletic Injuries / Q000601:surgery; D005260:Female; D006801:Humans; D008023:Ligaments, Articular / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D019736:Prostheses and Implants; D000068958:Return to Sport; D012783:Shoulder Dislocation / Q000601:surgery*; D013536:Suture Techniques; D055815:Young Adult
keywords: Acromioclavicular joint; Dislocation; LARS artificial ligament; Reconstruction