Comparing mini-open and arthroscopic acromioclavicular joint repair: functional results and return to sport.
BACKGROUND
Acromioclavicular joint (ACJ) dislocation is a common injury that can result from sports activities. The surgical technique for the treatment of Type III and Type IV injuries, according to the Rockwood classification, remains controversial. The purpose of the study was to determine the functional outcome after minimally invasive and arthroscopic surgery. The mini-open surgery was done with MINAR®system, whereas the arthroscopic technique was done with Dog BoneTMButton.


METHODS
Retrospective Cohort study.


METHODS
We reviewed 31 who were surgically treated for acute acromioclavicular dislocation Type III and Type IV (2012-2015). We excluded subjects with chronic dislocation or other injury. We selected 16 patients (average age 37).  Half of the sample patients were treated with mini-open surgery with the MINAR®system, and the other half of the patients were treated with the Dog Bone arthroscopic technique. The Constant Shoulder Score, the Oxford Shoulder Score, the Simple Shoulder Test and the Subjective Patient Outcome for Return to Sports (SPORTS) score were used to assess functional outcome of the treated shoulder.


RESULTS
Mean follow-up was 13 months (range 6-27 months). The mean Constant Shoulder Score was 91.10 (range 82.76-96.66), Oxford Shoulder Score was 46.19 (range 42.00-48.00), the Simple Shoulder Test was 10.50 (range 9.00-12.00), and the SPORTS score was 7.88 (range 3-10). There is a statistically significant difference between the sample operated with the mini-open surgery and the group operated with arthroscopic technique. The probability of return to their sport, according to the results of the SPORTS score, was significantly higher for patients treated with the MINAR®system (p < 0.001). However, the objective parameter of Constant scale is statistically better in patients operated by arthroscopic technique (p < 0.05; p < 0.001).


CONCLUSIONS
Restoration of ACJ anatomy is the key to a successful therapy. The surgical technique should be personalized. The miny-open surgery and also the arthroscopic surgery are adequate with good clinical results. However, according to the SPORTS score, the patients treated with mini-open surgery returned to their sport with less pain and better performance than those belonging to the other group.
Department of Orthopaedics and Traumatology, CTO and Maria Adelaide Hospital, University of Turin Medical School, 29, Via Zuretti, 10126, Turin, TO, Italy. mari.faggiani@hotmail.it.
M
M
Faggiani
Department of Orthopaedics and Traumatology, CTO and Maria Adelaide Hospital, University of Turin Medical School, 29, Via Zuretti, 10126, Turin, TO, Italy.
G P
GP
Vasario
Department of Orthopaedics and Traumatology, CTO and Maria Adelaide Hospital, University of Turin Medical School, 29, Via Zuretti, 10126, Turin, TO, Italy.
L
L
Mattei
Department of Orthopaedics and Traumatology, CTO and Maria Adelaide Hospital, University of Turin Medical School, 29, Via Zuretti, 10126, Turin, TO, Italy.
M J
MJ
Calò
Department of Orthopaedics and Traumatology, CTO and Maria Adelaide Hospital, University of Turin Medical School, 29, Via Zuretti, 10126, Turin, TO, Italy.
F
F
Castoldi
D000173:Acromioclavicular Joint / Q000293:injuries*; D000328:Adult; D001182:Arthroscopy / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D004204:Joint Dislocations / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D012189:Retrospective Studies; D000068958:Return to Sport; D015599:Trauma Severity Indices; D016896:Treatment Outcome
Acromioclavicular joint; Arthroscopic surgery; Mini-open surgery; Stabilization