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Acromioclavicular joint reconstruction with the LARS ligament in professional versus non-professional athletes

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To compare outcomes of acromioclavicular (AC) joint reconstruction with ligament augmentation and reconstruction system (LARS) ligament in professional and non-professional athletes at 2-year minimum follow-up.

Methods

Forty-three patients (men; mean age 30, range 19–54 years) with Rockwood type III to V chronic AC joint dislocations underwent AC joint reconstruction with LARS ligament and standardized rehabilitation. Patients were divided into two groups: professionals (22) and non-professionals (21). Clinical and radiological evaluations were performed preoperatively, at 3- and 24-month follow-up.

Results

All clinical (Oxford and Constant) scores and patient satisfaction improved significantly from preoperative to follow-up intervals (p < 0.00001). However, professionals showed nonsignificant improvements from 3- to 24-month follow-up in Constant. Although groups differed preoperatively in Constant (p = 0.037), they were not different in preoperative-to-postoperative differences in clinical scores, postoperative final satisfaction and median time to return to unrestricted activity [4 (interquartiler range 3–5) months to return to full sport in professionals]. Follow-up radiographs revealed an AC joint ratio (clavicle inferior-to-superior translation as ratio of AC joint height) of 0.09 and 0.16 in 8/22 professionals, 0.19 and 0.31 in 9/21 non-professionals, 0.14 and 0.24 in 17/43 overall patients at 3- and 24-month follow-up, respectively. Slight loss of reduction (0.25 < AC joint ratio < 0.50): 21 %. There were no significant clinical–radiographic correlations. Complication: one coracoid fracture at follow-up and one wound infection.

Conclusions

AC joint reconstruction with LARS ligament did not reveal differences in clinical outcomes between groups, with 2 % of failures (re-dislocations) at 2-year minimum follow-up. Superior radiological outcomes in professionals were not correlated to clinical results.

Level of evidence

Therapeutic study–prospective comparative study, Level II.

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Acknowledgments

The authors thank Linda Hallam, Federico Raggi, MD and Tommaso Roberti di Sarsina, MD for their help in data management.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Laboratorio di Biomeccanica – Istituto Ortopedico Rizzoli, University of Bologna, via di Barbiano, 1/10, 40100, Bologna, Italy

    Giulio Maria Marcheggiani Muccioli, Alberto Grassi & Stefano Zaffagnini

  2. Manchester University, Manchester, UK

    Christopher Manning

  3. Wrightington Hospital, Wigan, UK

    Philip Wright & Lennard Funk

  4. Salford University, Manchester, UK

    Lennard Funk

Authors
  1. Giulio Maria Marcheggiani Muccioli
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  2. Christopher Manning
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  3. Philip Wright
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  4. Alberto Grassi
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  5. Stefano Zaffagnini
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  6. Lennard Funk
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Corresponding author

Correspondence to Giulio Maria Marcheggiani Muccioli.

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Marcheggiani Muccioli, G.M., Manning, C., Wright, P. et al. Acromioclavicular joint reconstruction with the LARS ligament in professional versus non-professional athletes. Knee Surg Sports Traumatol Arthrosc 24, 1961–1967 (2016). https://doi.org/10.1007/s00167-014-3231-y

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  • DOI: https://doi.org/10.1007/s00167-014-3231-y

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