Podium (General) 08

Functional Outcome of Anatomic Coracoclavicular Ligament Reconstruction to Military personnel with Acromioclavicular joint Disruption � A Case Series a Retrospective Review

Andrie Lorenzo F Ortega, MD

BACKGROUND: Injuries to the acromioclavicular (AC) joint represent a spectrum of soft tissue disruptions that can result in mild, transient pain about the joint to significant displacement, chronic pain, and changes in shoulder biomechanics resulting in long- term disability. Albeit a less common alternative method, the surgical repair of AC joint disruptions through anatomic CC ligament reconstruction with autologous (hamstring) graft is performed in an effort to bring the AC joint as close as possible to their native anatomic location.

OBJECTIVE: This study aims to test the functional outcome to this type if fixation in terms of early return to work of patient with AC joint disruption Rockwood Grade III-V

METHODOLOGY: Military patients with Acromioclavicular Joint disruption grade III-V from 2019-2021 were treated with anatomic coracoclavicular ligament reconstruction using autologous graft. Inclusion criteria included all patients sustaining acute AC joint disruption Grade III-V and and indicated to undergo anatomic cc ligament reconstruction. Preoperative and postoperative DASH scores and radiographic findings were measured and recorded. Possible adverse effects and iatrogenic injuries were properly documented. All patients were followed-up at 8th weeks, three, and six months postoperatively.

RESULTS: All patients were between 33-43 years of age, with a mean age of 37 years. It was noted that the main mechanism of injury for all patients was attributable to direct trauma on the affected shoulder, and the grading of the injuries ranging from Rockwood Grade III to V. Significant improvement in the functional outcomes as reported by the DASH score is seen 6 months after the operation, leading to conclude the feasibility and effectiveness of this method in the treatment of AC joint disruptions.

All patients were discharged between 3 to 6 post-operative days. For radiographic findings, among the (4) four subjects,(3) three of them showed unremarkable findings, and a noteworthy finding included (1) one patient which showed an increase in CC distance (approximately measure 4-5mm increase). Nevertheless, the DASH scores and range of motion tests showed the improvement experienced by the patients, and hence they were instructed to continue therapy until 6 months post-operation.

CONCLUSION: The study was able to report the findings seen among four military personnel who underwent anatomic CC ligament reconstruction with autologous (hamstring) graft for the treatment of their AC joint disruption. Overall functional outcomes in terms of the DASH scores showed significant postoperative improvement among the patients, which could offer the orthopedic surgeon enough evidence bases to consider this treatment method to be performed for these kinds of injuries.