Clinical and radiographic outcomes following anatomic coracoclavicular ligament reconstruction using 4-strand taped suspensory fixation in an active-duty military population

Abstract

Background

Acromioclavicular (AC) joint injuries are common in young, active populations. However, there is a paucity of literature reporting surgical outcomes following the treatment of AC joint injuries in the military population. Therefore, the purpose of this study was to evaluate the clinical and radiographic outcomes of active-duty military members who underwent arthroscopic-assisted anatomic coracoclavicular ligament reconstruction using a 4-strand suspensory fixation with taped sutures for treatment of high-grade AC joint injuries with a minimum 1-year follow-up.

Methods

A retrospective review was performed on all patients with Rockwood grade IIIB-V AC joint separations who underwent anatomic coracoclavicular ligament reconstruction using a 4-strand suspensory fixation with taped sutures at a single military treatment facility between January 2015 and May 2022. Clinical outcome measures included the Single-Assessment Numerical Evaluation (SANE) score and patient satisfaction using the Likert Scale. Radiographic outcomes were measured by classifying the amount of residual AC joint separation on postoperative radiographs utilizing the Rockwood classification.

Results

Coracoclavicular ligament reconstruction a using 4-strand suspensory fixation with taped sutures was performed in 15 consecutive patients, all of which were active-duty military males with a mean age of 35.8 years. Preoperatively, there were 10 patients with grade IIIB injuries, 1 patient with a grade IV injury, and 4 patients with grade V injuries. The average preoperative SANE score was 40.0. The average length of time from injury to surgery was 46.5 weeks. Patient-reported outcomes were available for 12 of the 15 patients (80%) at an average of 4.9 years postoperatively with an average postoperative SANE score of 77.1 (P = .0002); 11 of these 12 patients (92%) reported they were either satisfied or extremely satisfied with the outcome of the surgery. Postoperative radiographs were available for 14 of the 15 patients (93%) at an average of 2.7 years postoperatively revealing 13 patients had maintained grade I reduction while 1 patient had a grade III separation.

Conclusion

Coracoclavicular ligament reconstruction a using 4-strand suspensory fixation with taped sutures resulted in significantly improved radiographic and patient-reported outcomes in this retrospective review of active-duty military members with grade IIIB-V AC joint separations.