Comparison Of Clinical Outcomes After Conservative Treatment And Coracoclavicular Ligament Reconstruction With Autogenous Peroneus Longus Tendon For Rockwood ? Acromioclavicular Joint Dislocations

Purpose: Because of the lack of Evidence-based medicine studies on the proper treatment for acromioclavicular joint injuries,the current treatment for Rockwood ? acromioclavicular joint dislocation remains controversial.In this study,we selected patients with Rockwood ? acromioclavicular dislocation and compared the clinical efficacy of using autogenous anterior half of the peroneus longus tendon(AHPLT)to reconstruct coracoclavicular ligament and conservative treatment.Methods: Patients with Rockwood type ? AC joint dislocations found by bilateral shoulder joint anteroposterior(AP)and axillary radiographs were eligible for this study.The magnetic resonance imaging(MRI)of the injured shoulders indicate rupture of the coracoclavicular ligaments and acromioclavicular ligaments.Patients were divided into 2 groups according to the different treatment.The indexes of two groups of patients were recorded.At 1,3,6 and 12 months of follow-up,the patients' Constant scores,Quick DASH scores,the visual analog scale(VAS)scores and the American Orthopedic Foot and Ankle Society(AOFAS)scores were recorded to evaluate the function and pain of shoulder joint.Results: 36 patients were included in the analysis.15 patients were in the AHPLT reconstruction group including 13 men and 2 women,aged 22 to 68 years,with an average of 50.53 years.21 patients were in the conservative group including 16 males and 5 females;aged 25 to 61 years,with an average of 45.95 years.At 12 th month,the Constant scores of AHPLT reconstruction group and conservative group are 95.27 and 97.02 respectively,which is significantly higher than those of pre-operation(49.8)or before conservative treatment(51.8);the Constant scores between the two groups were not statistically significant(P> 0.05).At 12 th month,the Quick DASH scores and VAS scores of both groups were significantly lower than those before operation or before conservative treatment(P <0.05).At the first month of follow-up,the Constant score was significantly higher in the conservative group than in the reconstructive group(P <0.05).At the 1st and 3rd month of follow-up,the Quick DASH score was significantly lower in the conservative group than in the reconstructive group(P <0.05).At the 1st,3rd and 6th month of follow-up,the VAS score was significantly lower in the conservative group than in the reconstructive group(P <0.05).Conclusion: For the Rockwood ? acromioclavicular joint dislocation,the use of AHPLT reconstruction or conservative treatment can both achieve satisfactory results.In the early stage of follow-up,patients treated conservatively may encounter less pain and achieve better clinical functions.