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Low prevalence of relevant associated articular lesions in patients with acute III–VI acromioclavicular joint injuries

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To define the prevalence of associated articular injuries in patients with severe (Rockwood’s III–VI) acute acromioclavicular joint injuries and to find out how many of these were associated with the traumatic event and required surgical treatment.

Methods

Retrospective observational multicentric study performed in ten centres included patients who required surgery for acute acromioclavicular joint injuries between 2010 and 2017. The inclusion criteria were: presence of an acute acromioclavicular joint injury (grades III–IV–V–VI) and surgical treatment within 3 weeks of injury that included a full arthroscopic evaluation of the shoulder. Basic epidemiological data, severity of the original injury, prelesional sport level and prelesional work site requirements were recorded. The presence of intraarticular glenohumeral lesions and information of their characteristics, treatment, and whether each lesion was considered acute or pre-existing was also recorded.

Results

Two-hundred one subjects [mean (SD) age 36.7 (11.7) years] with acute acromioclavicular joint injuries (110 Rockwood type III, 34 type IV, 56 type V and 1 type VI) fulfilled the inclusion criteria. A total of 28 (13.9%) associated articular lesions were found. These lesions were more often found in grade IV injuries (26.5% in grade IV vs 11.4% in grade III, p = 0.037) and presented in males (18.7% in males vs 4% in females, p = 0.015). Age, laterality, sport level or work requirements did not affect the prevalence of associated lesions. Twelve were rotator cuff tears (6 PASTA lesions, 3 partial supscapularis tears, 2 bursal supraspinatus tears and 1 full-thickness supraspinatus tear), 16 were labral tears (9 anterior, 1 posteroinferior and 6 SLAP). Only 14 (50% of lesions, 7% of total subjects) were considered acute and all but one (an SLAP type 2 tear) required further surgical attention. Most pre-existing lesions were left untreated (n = 7) or managed with minimal debridement (n = 6), and only two required further surgery. The prevalence of associated lesions that required surgical management was 7.46%.

Conclusions

The prevalence of relevant associated lesions in subjects with acute grade III to VI ACJI is relatively low. Only 14% of subjects have an associated lesion and only half of these required further surgical attention.

Level of evidence

Retrospective case series, level IV.

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Funding

No funding was obtained to perform this research.

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Authors and Affiliations

  1. Hospital Universitario Ramón y Cajal, Cta Colmenar km 9.100, Madrid, 28034, Spain

    Miguel Angel Ruiz Ibán & Jorge Diaz Heredia

  2. Universitat Autónoma de Barcelona, Barcelona, Spain

    Juan Sarasquete

  3. Hospital Universitario Montepríncipe, Madrid, Spain

    Mario Gil de Rozas

  4. Hospital Privado Boa Nova, Porto, Portugal

    Pedro Costa

  5. Hospital Universitario Cruces, Bilbao, Spain

    Juan Daniel Tovío

  6. Hospital da Luz, Lisbon, Portugal

    Eduardo Carpinteiro

  7. Hospital Universitari de Bellvitge, Barcelona, Spain

    Abdul Ilah Hachem

  8. Hospital Infanta Leonor, Madrid, Spain

    Manuel Perez España

  9. Hospital Asepeyo Coslada, Madrid, Spain

    Cristina Asenjo Gismero & Miguel García Navlet

Authors
  1. Miguel Angel Ruiz Ibán
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  2. Juan Sarasquete
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  3. Mario Gil de Rozas
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  4. Pedro Costa
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  5. Juan Daniel Tovío
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  6. Eduardo Carpinteiro
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  7. Abdul Ilah Hachem
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  8. Manuel Perez España
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  9. Cristina Asenjo Gismero
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  10. Jorge Diaz Heredia
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  11. Miguel García Navlet
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Correspondence to Miguel Angel Ruiz Ibán.

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The authors declare that they have no conflict of interest.

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IRB approval was obtained from the Clinical investigation and Ethics Committee of the Hospital Universitario Ramon y Cajal, Madrid, Spain.

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Ruiz Ibán, M.A., Sarasquete, J., Gil de Rozas, M. et al. Low prevalence of relevant associated articular lesions in patients with acute III–VI acromioclavicular joint injuries. Knee Surg Sports Traumatol Arthrosc 27, 3741–3746 (2019). https://doi.org/10.1007/s00167-018-5089-x

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  • DOI: https://doi.org/10.1007/s00167-018-5089-x

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