Reconstruction of Acute Acromioclavicular (AC) Joint Dislocations with or without Tendon Graft: a Retrospective Comparative Study

Background: Reconstructions of acute acromioclavicular (AC) dislocations have been thought to result in superioroutcomes than chronic dislocations. The use of tendon graft in reconstructions has demonstrated favorablebiomechanical properties. To determine whether utilizing tendon graft during repair of acute AC dislocations results insuperior outcomes and lower complication rate.Methods: A retrospective review of AC reconstructions was conducted. Reconstructions performed within 3 weeks ofinjury were included. Inclusion criteria included age over 18, grade 3-5 AC joint separation, and no previous ipsilateralshoulder injury. Primary outcome measure was radiographic loss of reduction. Secondary outcomes included ASESand SANE scores.Results: Of 47 reconstructions of acute AC joint separations, 35 utilized fixation without a tendon graft, while 12underwent an anatomic reconstruction with tendon graft. Repairs without the use of graft resulted in 8 (23%) casesof loss of reduction, while tendon graft augmented repairs resulted in 5 (42%). This difference was not statisticallysignificant (P = 0.22). No patients required reoperation. There was no statistical difference in the ASES and SANEscores between the two groups. Furthermore, we found no significant difference in ASES or SANE scores in patientswho maintained reduction postoperatively versus those that lost reduction.Conclusion: A greater but not statistically significant rate of loss of reduction was observed in the group reconstructedwith the use of a tendon graft. Further research is needed to determine whether the use of tendon graft is beneficial inthe treatment of acute AC joint separations.Level of evidence: IV