Associated Lesions Requiring Additional Surgical Treatment in Grade 3 Acromioclavicular Joint Dislocations

• Published in: Arthroscopy Vol. 30; no. 1; pp. 6 - 10
• Main Authors: Arrigoni, Paolo, M.D, Brady, Paul C., M.D, Zottarelli, Leonardo, M.D, Barth, Johannes, M.D, Narbona, Pablo, M.D, Huberty, David, M.D, Koo, Samuel S., M.D., Ph.D, Adams, Christopher R., M.D, Parten, Peter, M.D, Denard, Patrick, M.D, Burkhart, Stephen S., M.D
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 2014
• Subjects: Acromioclavicular Joint - injuries; Adolescent; Adult; Age Factors; Aged; Arm Injuries - epidemiology; Arm Injuries - surgery; Arthroscopy; Chronic Disease; Comorbidity; Female; Humans; Humeral Head - injuries; Humeral Head - surgery; Incidence; Joint Instability - epidemiology; Joint Instability - surgery; Male; Middle Aged; Orthopedics; Prognosis; Retrospective Studies; Risk Factors; Rotator Cuff - surgery; Rotator Cuff Injuries; Shoulder Dislocation - epidemiology; Shoulder Dislocation - surgery; Tendon Injuries - epidemiology; Tendon Injuries - surgery; Young Adult
• ISSN: 0749-8063; 1526-3231
• DOI: 10.1016/j.arthro.2013.10.006

Purpose To evaluate the incidence of associated pathologic shoulder lesions that were addressed surgically in grade 3 acromioclavicular joint (ACJ) dislocations, as well as to compare this incidence between younger and older patients and between acute and chronic cases. Methods In this multicenter nonrandomized retrospective study, 98 patients operated on for grade 3 ACJ dislocation underwent concomitant arthroscopic evaluation for the identification and treatment of any associated lesions. The type and treatment of associated lesions were collected in a central database and analyzed. We classified patients according to age (<45 years and ≥45 years) and according to the length of time between trauma and surgical treatment (≤30 days and ≥120 days), obtaining the following stratification: younger acute, older acute, younger chronic, and older chronic. Results Of the patients, 42 (42.8%) were diagnosed with at least 1 additional pathologic lesion, and 29 (29.5%) required a dedicated additional treatment. Rates of treatment on associated lesions were analyzed: younger versus older groups presented a significant difference, as did younger acute versus older acute groups; SLAP and posterior rotator cuff tear treatments represented 24 of the 35 additional surgeries (68.5%). Conclusions The overall rate of associated pathologic lesions requiring additional surgical treatment in patients with ACJ dislocation was 29.5%. Patients aged 45 years or older had a greater risk of presenting with associated lesions that needed to be surgically addressed (odds ratio, 3.01). The overall rates of associated surgical lesions in acute versus chronic cases were not shown to be significantly different. Level of Evidence Level IV, prognostic case series.