Acromioclavicular Joint Dislocation
Conditions
Keywords
shoulder, orthopaedics
Brief summary
To evaluate patient function, radiographic changes and complication rates of acute coracoclavicular (CC) joint reconstruction with and without the use of tendon graft as an augmentation to repair.
Detailed description
Acromioclavicular (AC) joint dislocations comprise up to 12% of shoulder girdle injuries. Many methods of reconstructing the coracoclavicular ligaments, which provide vertical stability of the acromioclavicular joint, have been described. The use of tendon graft to augment the reconstruction provides improved biomechanical stability, less radiographic changes postoperatively including loss of reduction, and improved function. However, the use of a tendon graft necessitates larger drill holes in the clavicle when compared to suture-only repair constructs. The size and placement of these tunnels in the clavicle have been associated with a higher rate of complications. It has been shown that repairs in the setting of acute injury demonstrate less complications including loss of reduction when compared with chronic dislocations. However, other reports describing repair of acute AC joint dislocations without graft augmentation have described significant changes in coracoclavicular distance with routine follow up radiographs, and up to 90% implant migration rates. While use of tendon graft would be expected to provide further stability, they may in turn cause an increased complication rate. 1. To determine complication rates in the reconstruction of AC joint dislocations with and without the use of tendon graft. 2. Determine patient satisfaction, the ASES, Constant, SF-12, SANE, SST scores of shoulders that undergo reconstruction of acute AC joint dislocations with and without the use of graft. 3. The investigation aims to determine whether or not graft should be used in the reconstruction of acute AC joint dislocations.
Interventions
PROCEDUREtendon graft
JRF Orthopedics Tendon Graft
OTHERNo intervention
No intervention
Sponsors
Cedars-Sinai Medical Center
Kerlan-Jobe Institute
White Memorial Hospital
Dr. Brian Lee
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Displaced acromioclavicular joint dislocation sustained within 3 weeks of surgery * recommended for operative fixation * age 18 years or older
Exclusion criteria
* Open dislocation * previous acromioclavicular surgery * unable to follow study protocol * concomitant injury requiring surgery (rotator cuff repair, biceps tenotomy/tenodesis) * active infection * unable to follow postoperative rehabilitation guidelines * reconstruction with coracoclavicular screw or hook plate.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Visual Analog Score (VAS) | 2 years | Measurement of shoulder pain from 0 (no pain) to 10 (unbearable distress) |
| Complication Rates with and without the use of graft tendons | 2 years | loss of radiographic reduction, infection, need for more surgery |
| (American Shoulder Elbow Society (ASES) | 2 years | Shoulder Function survey (17 multiple choice questions). |
| Instability Index Constant Score (ISIS) | 2 years | Shoulder Instability survey for last 4 weeks (yes/no and multiple choice). Score is graded poor, fair, good, excellent. |
| Simple Shoulder Test (SST) | 2 years | Shoulder Function survey (12 yes/no questions) |
| Short Form-12 | 2 years | This survey assesses patient's health satisfaction. This information will help keep track of how patients feel and how well patients are able to do your usual activities. (12 multiple choice questions) |
| Single Assessment Numerical Evaluation (SANE) | 2 years | Patient assessment rating from 0-100 shoulder normality |
Countries
United States
Contacts
Primary ContactStudy Coordinator
Outcome results
None listed