Clavicle and coracoid process periprosthetic fractures as late post-operative complications in arthroscopically assisted acromioclavicular joint stabilization

• Published in: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA Vol. 27; no. 12; pp. 3797 - 3802
• Main Authors: Thangaraju, Siva, Tauber, Mark, Habermeyer, Peter, Martetschläger, Frank
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-12-2019; Springer Nature B.V
• Subjects: Acromioclavicular Joint - surgery; Adult; Aged; Arthroscopy; Biocompatibility; Biomedical materials; Clavicle; Clavicle - diagnostic imaging; Clavicle - injuries; Clavicle - surgery; Complications; Coracoid Process - diagnostic imaging; Coracoid Process - injuries; Disruption; Elbow; Elbow (anatomy); Female; Fracture Fixation, Internal; Fractures; Humans; Immobilization; Joint Instability - surgery; Male; Males; Medical personnel; Medicine; Medicine & Public Health; Morphology; Orthopedics; Osteosynthesis; Patients; Periprosthetic Fractures - therapy; Postoperative Complications; Radiography; Shoulder; Stabilization; Surgery; Trauma; Late fracture complication; Arthroscopic-assisted stabilization; Clavicular tunnel widening; Arthroscopy; Periprosthetic fracture; Acromioclavicular joint
• ISSN: 0942-2056; 1433-7347
• DOI: 10.1007/s00167-019-05482-7

Purpose
Arthroscopic-assisted stabilization surgery for acute acromioclavicular joint (ACJ) disruption shows excellent and reliable clinical outcomes. However, characteristic complications such as fracture of the clavicle and coracoid have been reported to occur during the early post-operative period. The main goal of this study was to highlight the occurrence of fractures as a late post-operative complication. The secondary goals were to describe possible fracture morphologies and treatment outcomes.
Method
Patient records from a single surgery centre were searched for all patients presenting with late fracture complication following arthroscopically assisted acromioclavicular stabilization. Medical reports including the operative notes and pre- and post-operative X-rays were reviewed. A telephone interview was conducted with each patient to access the American Shoulder and Elbow Surgeons shoulder score.
Results
A total of four patients presented with late fracture complication following arthroscopic-assisted ACJ stabilization surgery. All patients were males and presented following trauma at a median duration of 19.5 months after the index surgery. Fracture morphology differed between patients; the treatment was conservative in three patients, while one patient underwent osteosynthesis.
Conclusion
Traumatic peri-implant fractures can occur, even 2 years after arthroscopically assisted ACJ reconstruction. This needs to be considered when planning for surgical intervention in acute ACJ disruption, especially in a high-risk population.
Level of evidence
Therapeutic study, Level IV.