Evaluation of surgical management of Rockwood Type 3 acromioclavicular joint injuries by autogenous semitendinosus graft ligament reconstruction: A retrospective study

Abstract

Background: As many as 40% of the shoulder injuries involve acromioclavicular (AC) joint. AC joint injuries have been classified by Rockwood into six types. Treatment of Type 3 AC joint injuries has been controversial. We present a series of 15 cases of Rockwood Type 3 AC joint injuries treated surgically with a method that addresses both superior- inferior as well as anteroposterior AC joint instability. Materials and Methods: Fifteen cases of Rockwood Type 3 AC joint injuries presented to us between November 2011 and November 2015. There were 11 male and four female patients. All patients were treated surgically with the reconstruction of AC and coracoclavicular (CC) ligaments using autogenous semitendinosus graft. The patients were evaluated pre operatively and postoperatively by radiological and functional (using American Shoulder and Elbow Surgeons [ASES] and Constant-Murley scores) methods. Results: X-rays done immediate postoperatively and at 6 weeks, 6 months, and 12 months postoperatively showed good maintenance of the reduction of the AC joint. The ASES score improved from a preoperative score of 41 to a postoperative score of 81 and 95 at 6 and 12 months, respectively. Constant-Murley score improved from a preoperative score of 42 to a post operative score of 79 and 93 at 6 and 12 months, respectively. Conclusion: Surgical management of Rockwood Type 3 AC joint injuries by AC and CC ligament reconstructions using autogenous semitendinosus graft leads to good functional results.

Keywords

• acromioclavicular and coracoclavicular ligaments
• acromioclavicular joint
• autogenous semitendinosus graft