A prospective study on the functional outcome of open biological reconstruction of acromioclavicular joint dislocation with semitendinosus tendon autograft

Abstract

Background: Acromioclavicular joint (ACJ) dislocations are common injuries, particularly in young adults involved in contact sports. While conservative treatment is the gold standard for Rockwood type I and II injuries, surgical intervention is often recommended for type IV to VI dislocations. The management of type III injuries remains controversial, with surgical reconstruction being preferred for physically active individuals. Thus, the study aimed to evaluate the functional outcomes of open biological reconstruction of ACJ dislocations using a semitendinosus tendon autograft. Materials and Methods: A prospective cohort study was conducted between July 2022 and December 2023, involving 15 patients with Rockwood type III to type VI ACJ dislocations. Patients with Rockwood type I and II dislocations, previous shoulder surgeries, or contraindications to surgery were excluded. The surgical procedure involved grafting the semitendinosus tendon around the coracoid process and through clavicular tunnels to stabilize the joint. Postoperative care included immobilization, K-wire removal, and a structured rehabilitation protocol. Outcome measures included functional assessments using Constant and ASES scores, VAS pain scores, and radiographic evaluations. Results: The study population had a mean age of 40.53±11.01 years, with 93.33% being male. Rockwood type III dislocations were the most common (86.67%), and road traffic accidents were the leading cause of injury (80%). Postoperative assessments showed significant improvements in Constant scores (22.8±7.15 pre-op vs. 88±8.76 post-op), ASES scores (23.4±5.3 pre-op vs. 86.33±9.27 post-op), and VAS pain scores (6.13±1.19 pre-op vs. 1±1.2 post-op) with a p-value of 0.0007. Complications were minimal, with one case of wound infection and one case of loss of reduction. Conclusion: Open biological reconstruction using a semitendinosus tendon autograft significantly improves functional outcomes in ACJ dislocations, with minimal complications.