title: Loss of reduction and complications of coracoclavicular ligament reconstruction with autogenous tendon graft in acute acromioclavicular dislocations.
abstract: BACKGROUND
  This study was conducted to report loss of reduction and complications after single-tunnel coracoclavicular (CC) ligament reconstruction with autogenous semitendinosus tendon graft for acute acromioclavicular (AC) joint dislocations.
  
  
  METHODS
  This retrospective study included patients with acute, unstable AC dislocations (surgery within 6 weeks after trauma). We excluded patients with chronic injury and distal clavicle fractures with CC ligaments disruption. We measured the CC distance on anteroposterior radiographs of both clavicles, preoperatively, immediately postoperatively, and at the final follow-up visit. We evaluated clinical outcomes using the American Shoulder and Elbow Surgeons Shoulder Assessment and the University of California, Los Angeles Shoulder Rating Scale scores and perioperative complications.
  
  
  RESULTS
  There were 30 patients (27 men and 3 women) with mean age of 41 years (range, 19-70 years). The mean follow-up period was 31 months (range, 12-186 months). Mean CC distance was 15.5 ± 3.7 mm (84% ± 14% of the contralateral shoulder) preoperatively, 8.9 ± 2.6 mm (9% ± 40%) immediately postoperatively (P < .001), and 10.6 ± 3.3 mm (24% ± 39%) at the final assessment (P < .001), showing an increase of the CC distance during the follow-up. Loss of reduction (defined as >25% increase of CC distance) developed in 14 patients (47%), and complications occurred in 6 patients (20%), including 3 distal clavicle fractures through the tunnel. Final clinical scores were significantly lower in patients with complications (27 vs. 33 of the University of California, Los Angeles assessment [P < .001] and 81 vs. 95 of the American Shoulder and Elbow Surgeons Shoulder assessment [P < .001]).
  
  
  CONCLUSIONS
  In acute AC joint dislocation, single-tunnel CC ligament reconstruction using autogenous tendon graft resulted in loss of reduction rate of 47% and a complication rate of 20%. The development of complications adversely affected clinical outcomes.
authors.affiliation: Department of Orthopaedic Surgery, Eulji Hospital, Eulji University School of Medicine, Seoul, Republic of Korea.
authors.forename: Nam Hong
authors.initials: NH
authors.lastname: Choi
authors.affiliation: Department of Orthopaedic Surgery, Eulji Hospital, Eulji University School of Medicine, Seoul, Republic of Korea.
authors.forename: Seok Min
authors.initials: SM
authors.lastname: Lim
authors.affiliation: Department of Orthopaedic Surgery, Eulji Hospital, Eulji University School of Medicine, Seoul, Republic of Korea.
authors.forename: Sang Young
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, Eulji Hospital, Eulji University School of Medicine, Seoul, Republic of Korea. Electronic address: shouldertk@gmail.com.
authors.forename: Tae Kang
authors.initials: TK
authors.lastname: Lim
mesh_terms: D000173:Acromioclavicular Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D000328:Adult; D000368:Aged; D064592:Autografts; D002968:Clavicle / Q000000981:diagnostic imaging / Q000293:injuries; D000070597:Coracoid Process / Q000000981:diagnostic imaging; D005260:Female; D050723:Fractures, Bone / Q000209:etiology; D006801:Humans; D008023:Ligaments, Articular / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D011184:Postoperative Period; D011859:Radiography; D012189:Retrospective Studies; D012783:Shoulder Dislocation / Q000601:surgery*; D013710:Tendons / Q000637:transplantation*; D055815:Young Adult
keywords: AC joint; acute, acromioclavicular joint; complication; reconstruction; tendon graft