title: Complication rates and types of failure after arthroscopic acute acromioclavicular dislocation fixation. Prospective multicenter study of 116 cases.
abstract: OBJECTIVE
  To report and analyze both the surgical and radiographic complications associated with anatomic coracoclavicular (CC) ligament procedures and to evaluate the effect of these complications on patient outcomes.
  
  
  METHODS
  From July 2012 to July 2013, 116 primary anatomic CC ligament procedures (all arthroscopic endobutton fixations) were performed in 14 different centers. Demographic, surgical, subjective, and radiographic data were prospectively analyzed in 14 centers with a minimum follow-up of 12 months.
  
  
  RESULTS
  This series included 96 men and 20 women, mean age 37 years old, with a mean delay to surgery of 10 days. No intraoperative complications were reported. There were 11 complications due to hardware failure resulting in a loss of reduction, 1 coracoid fracture, 7 cases of adhesive capsulitis, 2 local infections, 5 cases of hardware pain. There were significant differences in outcomes between patients who did and did not develop complications: mean CS=71 vs. 93, (P<0.0001). All the parameters of the CS were statistically affected (P<0.0001). Forty-eight patients had persistent dislocation>150% on an AP X-ray which affected the pain and activity CS (P=0.023 and P=0.044). No preoperative predictive factors were identified. These patients could not return to the same level of sports activities due to persistent pain.
  
  
  CONCLUSIONS
  Anatomic procedures to treat AC joint dislocation using CC ligament reconstruction resulted in an overall complication rate of 22.4% and influenced the return to sports. Good to excellent outcomes were reported in patients without complications.
  Level of evidence 4.
authors.affiliation: Service de chirurgie du membre supérieur, CCOM, 10, avenue Baumann, 67400 Illkirch-Graffenstaden, France. Electronic address: Philippe.clavert@chru-strasbourg.fr.
authors.forename: P
authors.initials: P
authors.lastname: Clavert
authors.affiliation: Chirurgie de l'épaule, groupe Maussins, 67, rue de Romainville, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Meyer
authors.affiliation: Service de chirurgie orthopédique, hôpital Bichat, AP-HP, 46, rue Henri-Huchard, 75877 Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Boyer
authors.affiliation: Institut universitaire de l'appareil locomoteur et du sport, CHU Nice-Pasteur 2, 30, voie Romaine, CS51069, 06001 Nice cedex 1, France.
authors.forename: O
authors.initials: O
authors.lastname: Gastaud
authors.affiliation: Centre ostéo-articulaire des Cèdres, Parc Sud Galaxie, 5, rue des Tropiques, Échirolles, France.
authors.forename: J
authors.initials: J
authors.lastname: Barth
authors.affiliation: Service de chirurgie orthopédique et traumatologique, hôpital Charles-Nicolle, 1, rue de Germont, 76031 Rouen cedex, France.
authors.forename: F
authors.initials: F
authors.lastname: Duparc
mesh_terms: D000173:Acromioclavicular Joint / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D000328:Adult; D000368:Aged; D001182:Arthroscopy / Q000009:adverse effects* / Q000379:methods; D002062:Bursitis / Q000209:etiology; D005260:Female; D050723:Fractures, Bone / Q000209:etiology*; D006801:Humans; D016268:Internal Fixators / Q000009:adverse effects; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000601:surgery*; D008023:Ligaments, Articular / Q000293:injuries* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology; D011446:Prospective Studies; D011859:Radiography; D000068958:Return to Sport; D012540:Scapula; D013530:Surgical Wound Infection / Q000209:etiology*; D061665:Time-to-Treatment; D017211:Treatment Failure; D055815:Young Adult
keywords: Acromioclavicular joint; Arthroscopy; Complication; Failure; Shoulder