Early complications of acromioclavicular joint reconstruction requiring reoperation.
OBJECTIVE
Prior studies have reported high complication rates with acromioclavicular joint reconstruction (ACJR). However, many of these reports have suffered from small sample sizes and inclusion of older surgical techniques. The purpose of this study was to determine the rates of early complications requiring reoperation in patients treated with ACJR.


METHODS
From 2007 to 2011, patients who were treated with ACJR were identified using the PearlDiver database, a large insurance database in the USA. The following reoperations were then queried from this patient cohort: irrigation and debridement within 30 days of index surgery, manipulation under anaesthesia (MUA) of the shoulder joint within 3 months of index surgery, and revision ACJR, distal clavicle excision, and removal of hardware within 6 months of index surgery.


RESULTS
In total, 2106 patients treated with ACJR were identified. The reoperation rates for irrigation and debridement, MUA, revision ACJR, distal clavicle excision, and removal of hardware were 2.6, 1.3, 4.2, 2.8, and 6.2 %, respectively. Patients ≥35 years of age and females more likely to undergo a reoperation after ACJR. Specifically, patients ≥35 years of age were more likely to undergo MUA and revision ACJR, while patients ≥50 years of age were more likely to undergo an irrigation and debridement. Females were more likely than males to undergo revision ACJR and distal clavicle excision.


CONCLUSIONS
Older patients and females were more likely to experience postoperative complications requiring reoperations, including revision ACJR, distal clavicle excision, and irrigation and debridement. By analysing a large cohort of patients across multiple centres and providers, this study provides valuable insight into the recent complication profiles of ACJR, allowing surgeons to appropriately counsel patients on the risks of these procedures.


METHODS
IV.
Department of Orthopaedic Surgery, David Geffen School of Medicine, University of California, Los Angeles (UCLA), 10833 Le Conte Ave, 76-143 CHS, Box 956902, Los Angeles, CA, 90095-6902, USA. deanwangmd@gmail.com.
Dean
http://orcid.org/0000-0002-3005-1154
D
Wang
Department of Orthopaedic Surgery, David Geffen School of Medicine, University of California, Los Angeles (UCLA), 10833 Le Conte Ave, 76-143 CHS, Box 956902, Los Angeles, CA, 90095-6902, USA.
Benjamin E
BE
Bluth
Department of Orthopaedic Surgery, David Geffen School of Medicine, University of California, Los Angeles (UCLA), 10833 Le Conte Ave, 76-143 CHS, Box 956902, Los Angeles, CA, 90095-6902, USA.
Chad R
CR
Ishmael
Department of Orthopaedic Surgery, David Geffen School of Medicine, University of California, Los Angeles (UCLA), 10833 Le Conte Ave, 76-143 CHS, Box 956902, Los Angeles, CA, 90095-6902, USA.
Jeremiah R
JR
Cohen
Orthopaedic Spine Service, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Jeffrey C
JC
Wang
Department of Orthopaedic Surgery, David Geffen School of Medicine, University of California, Los Angeles (UCLA), 10833 Le Conte Ave, 76-143 CHS, Box 956902, Los Angeles, CA, 90095-6902, USA.
Frank A
FA
Petrigliano
D000173:Acromioclavicular Joint / Q000601:surgery*; D000328:Adult; D000367:Age Factors; D000368:Aged; D002968:Clavicle / Q000601:surgery; D015331:Cohort Studies; D016208:Databases, Factual; D003646:Debridement / Q000706:statistics & numerical data; D020878:Device Removal / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008349:Manipulation, Orthopedic / Q000706:statistics & numerical data; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery*; D012086:Reoperation / Q000706:statistics & numerical data*; D012737:Sex Factors; D007507:Therapeutic Irrigation / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology
Acromioclavicular; Complications; Reconstruction; Reoperation; Shoulder