Return to sport after arthroscopic double endo-button fixation for acute acromioclavicular dislocation: One-year functional outcomes.

Introduction: Acromioclavicular joint dislocation (ACJD) is a common injury among athletes. Few studies have investigated clinical outcomes following arthroscopic surgery for high-grade acute ACJD. This study aims to determine whether arthroscopic stabilization using a double-button fixation system enables an optimal return to sports in terms of timing and level, with a minimum follow-up of one year postoperatively.

Materials and methods: This prospective, single-center study included patients who underwent arthroscopic stabilization with a double-button fixation system for severe acute ACJD (Rockwood grade ≥3) between 2016 and 2023. Return-to-sport timing and level of performance were assessed via questionnaire, clinical outcomes were evaluated using the self-reported Constant score, Subjective Shoulder Value (SSV), and a satisfaction score. Radiographic assessments were systematically performed, with a minimum follow-up of one year.

Results: A total of 30 patients with Rockwood grade III to V ACJD were included. The mean time to return to sports was 5 months, and the mean self-reported Constant score was 96 at one year postoperatively, with no residual pain or limitations in range of motion. 82% of patients reported returning to a pre-injury level of sports. The average duration of work absence was 3 months. Smoking was identified as a factor correlating to a negative Constant score at the final follow-up.

Conclusion: At more than one year of follow-up, arthroscopic surgery for acute ACJD allows a return to sports after an average of 5 months, with clinical outcomes comparable to open techniques. This approach offers a minimally invasive procedure, a single surgical intervention, and precise assessment of shoulder pathology.

Level of evidence: IV; Descriptive, single-center, prospective observational study.