title: Return-to-activity after anatomical reconstruction of acute high-grade acromioclavicular separation.
abstract: BACKGROUND
  To evaluate return-to-activity (RtA) after anatomical reconstruction of acute high-grade acromioclavicular joint (ACJ) separation.
  
  
  METHODS
  A total of 42 patients with anatomical reconstruction of acute high-grade ACJ-separation (Rockwood Type V) were surveyed to determine RtA at a mean 31 months follow-up (f-u). Sports disciplines, intensity, level of competition, participation in overhead and/or contact sports, as well as activity scales (DASH-Sport-Module, Tegner Activity Scale) were evaluated. Functional outcome evaluation included Constant score and QuickDASH.
  
  
  RESULTS
  All patients (42/42) participated in sporting activities at f-u. Neither participation in overhead/contact sports, nor level of activity declined significantly (n.s.). 62 % (n = 26) of patients reported subjective sports specific ACJ integrity to be at least the same as prior to the trauma. Sporting intensity (hours/week: 7.3 h to 5.4 h, p = .004) and level of competition (p = .02) were reduced. If activity changed, in 50 % other reasons but clinical symptoms/impairment were named for modified behavior. QuickDASH (mean 6, range 0-54, SD 11) and DASH-Sport-Module (mean 6, range 0-56, SD 13) revealed only minor disabilities at f-u. Over time Constant score improved significant to an excellent score (mean 94, range 86-100, SD 4; p < .001). Functional outcome was not correlated with RtA (n.s.).
  
  
  CONCLUSIONS
  All patients participated in sporting activities after anatomical reconstruction of high-grade (Rockwood Type V) ACJ-separation. With a high functional outcome there was no significant change in activity level (Tegner) and participation in overhead and/or contact sports observed. There was no correlation between functional outcome and RtA. Limiting, there were alterations in time spent for sporting activities and level of competition observed. But in 50 % those were not related to ACJ symptoms/impairment. Unrelated to successful re-established integrity and function of the ACJ it should be considered that patients decided not return-to-activity but are very content with the procedure.
authors.affiliation: Department of Orthopedic Sports Medicine, Technische Universität München, Munich, Germany.|Department of Reconstructive Joint Surgery, Berufsgenossenschaftliche Unfallklinik Murnau, Murnau, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Saier
authors.affiliation: Department of Orthopedic Sports Medicine, Technische Universität München, Munich, Germany.
authors.forename: J E
authors.initials: JE
authors.lastname: Plath
authors.affiliation: Department of Orthopedic Sports Medicine, Technische Universität München, Munich, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Beitzel
authors.affiliation: Chirurgische Klinik Dr. Rinecker, Munich, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Minzlaff
authors.affiliation: Department Orthopedics and Traumatology University of Freiburg, Freiburg, Germany.
authors.forename: J M
authors.initials: JM
authors.lastname: Feucht
authors.affiliation: Department of Orthopedic Sports Medicine, Technische Universität München, Munich, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Reuter
authors.affiliation: Department of Orthopedic Sports Medicine, Technische Universität München, Munich, Germany.|Center for Shoulder and Elbow Surgery, ATOS Clinic Munich, Munich, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Martetschläger
authors.affiliation: Department of Orthopedic Sports Medicine, Technische Universität München, Munich, Germany. a.imhoff@sportortho.de.
authors.forename: Andreas B
authors.initials: AB
authors.lastname: Imhoff
authors.affiliation: Department of Orthopedic Sports Medicine, Technische Universität München, Munich, Germany.|Department of Orthopaedic Surgery, Mansoura University, Mansoura, Egypt.
authors.forename: M
authors.initials: M
authors.lastname: Aboalata
authors.affiliation: Department of Orthopedic Sports Medicine, Technische Universität München, Munich, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Braun
mesh_terms: D000173:Acromioclavicular Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D000328:Adult; D001182:Arthroscopy / Q000009:adverse effects / Q000379:methods*; D001265:Athletic Injuries / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D001696:Biomechanical Phenomena; D003163:Competitive Behavior; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D020127:Recovery of Function; D012189:Retrospective Studies; D000068958:Return to Sport; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Acromioclavicular; Acromioclavicular separation; Arthroscopy; Reconstruction; Return-to-activity; Returnto-sports; Rockwood V; Tight-rope; suture button device