Acute grade III and IV acromioclavicular dislocations: outcomes and pitfalls of reconstruction procedures using a synthetic ligament.

Summary Introduction Acromioclavicular dislocation (ACD) is frequent, at 8% of all shoulder traumas. Management in grade III lesions remains controversial. The present study assessed objective and subjective results at medium-term follow-up (mean, 60 months; range, 12–120 mo) in 27 patients managed by Ligastic ® ligament reconstruction for acute dislocation. Patients and methods This is a multicenter, multi-surgeon retrospective study. Between 1998 and 2006, 59 patients were operated on for grade III or IV ACD, in one teaching hospital (Lille, France) and one general hospital (Tourcoing, France). Follow-up was performed by an independent (non-operator) observer. The 27 acute cases followed up underwent comparative bilateral radioclinical shoulder examination. Initial X-ray assessment found 14 grade-III (52%) and 13 grade-IV (48%) dislocations using Patte's classification. Results Mean Constant score was significantly lower on the operated side (82.44 vs 90.04; p p Conclusion In light of literature findings and our own experience, surgery is not to be recommended in grade-III ACD, and the authors have given up use of this device in this group due to the rate of associated osteolysis. Level of evidence Level IV.