Acromion Clavicular Joint Reconstruction with LARS Ligament in Acute Dislocation

Background: The acromion clavicular joint dislocations are common injuries of the shoulder. The severity is dependentupon the degree of ligamentous injury. Surgical treatment is typically performed in higher grade acromioclavicularseparation with several static and dynamic operative procedures with or without primary ligament replacement.Methods: 47 patients with acute Rockwood type III, IV, and V injuries were treated surgically with LARS reconstruction.The success of technique was evaluated by radiographic outcomes for each patient at every follow-up visit (one,three, 12 months), while to assess pain reduction and clinical evaluation Visual Analogue scale score (VAS) andConstant-Murley score (CMA) was performed, respectively. An One Way Analysis of Variance (Kruskal-Wallis test), amultiple comparison Turket test, or a t-test (Mann-Whitney Rank Sum Test) were used when required.Results: Follow-up radiographs revealed maintenance of anatomical reduction in 41 patients, and no bone erosionshas been identified. In short-term joint functional recovery has been observed. Indeed, after 12 months pain on theVAS-scale in all groups decreased significantly (P < 0.05), and the CMS revealed a significant overall improvement(P < 0.05).Conclusion: These data demonstrate that the use of the LARS allows to provide stability to the joint and especially toensure its natural elasticity, relieving pain and improving joint function already one month post-surgery.Level of evidence: III

Keywords:

acromionclavicular joint , coracoclavicular ligament reconstruction , coracoid process , shoulder injury