AC joint reconstruction with an anatomical PET synthetic ligament in athletes and non-athletes. Clinical and radiological outcomes at 2-year minimum follow-up.

Authors: G M Marcheggiani Muccioli*, C Manning, P Wright, L Funk

References: KSSTA Journal 2014

Aims: To prospectively evaluate the outcomes of ACJ reconstruction of an anatomical Polyethylenetetraphalate (PET) synthetic ligament and compare elite/professional athletes with non-athletes.

Methods: Fourty-three patients (mean age 30, with range 19-54 years) with Rockwood type 3 to 5 ACJ dislocations underwent surgical reconstruction with PET ligament. There were 21 athletes and 22 non-athletes.
Outcome measures included Constant scores at 3 and over 24-month follow-up intervals,and time to return to sport. Radiographic displacement was measured as a percentage of the acromioclavicular heighten standardised Zanca views.

Results: Mean time to surgery from injury was 3 months (range 0.25 to 20) for the athletes and 8.3 months (range 0.5 to 24) for the non-athletes.
Constant scores improved significantly both short and long-term in both groups.
The mean return to full sport was 4.5 months (range 3 to 8) in the athletes.
Mean displacement was 14% and 24% overall patients at 3 and 24-month follow-up, respectively, with significantly more displacement in the non-professional group - 9% and 16% in 8 professional athletes, 19% and 31% in 10 non-professional players. Patients with radiological displacement showed no significant differences in their in Constant scores compared to patients without displacement.
Complications included one coracoid fracture 16 months after the surgery after a new high impact tackling injury and one superficial infection.

Conclusion: ACJ reconstruction with synthetic PET ligament is a reliable, reproducible procedure for both elite athletes and non-athletes, with good clinical and radiographic outcomes.