A Novel Anatomical Double Bundle Acromioclavicular Joint Reconstruction with Semi Tendinosus Graft-A Functional Outcome Assessment Study in a Tertiary Care Hospital Of Eastern India.

Abstract

Aim: To assess the functional outcome of surgical treatment using anatomical double bundle acromioclavicular Joint Reconstruction (ACJR) with Semitendinosus graft (STG), a novel technique for the treatment of acromioclavicular joint (ACJ) dislocation.

Methods: In this prospective study, patients with ACJ dislocation with acute (< 6 weeks) and chronic injury (> 6 weeks), categorized according to Rockwood classification were included, operated using a novel technique. Patients were evaluated using Oxford shoulder score (OSS) and visual analog score (VAS) at months 1, 3, 6 and 12.

Results: Of the thirty adult patients (males 22; females 08), 5, 10 and 15 were in Rockwood Grade 3, 4 and 5, respectively. The mean ± SD age was 33 ± 7.5 years (range 18-48 years). Right sided injury (n = 18), involvement of dominant side (n = 21) was more frequent. The mean duration from the time of injury to surgery was 15 days (range 4-26 days). The mean follow-up period was 12 months (range 8-16 months). The mean OSS improved from 26 ± 7.3 to 37.88 ± 5.78 at month 3 and 44 ± 6.4 (P = 0.001) at month 12; VAS score increased from a mean 8.5 ± 1.02 at baseline to 3.53 ± 1.42 at month 3 and 0.95 ± 0.22 at month 12 (P = 0.001). The outcome was satisfactory in 86.66% patients while 13.34% had mild shoulder dysfunction. Intermittent mild pain without any functional disability (n = 02), and a moderate restriction of shoulder movements (n = 01) were reported.

Conclusion: ACJR using anatomical double bundle STG in ACJ dislocation is a functional, efficient, reproducible and cost-effective procedure in all the patients including sportspersons and high demand professionals.