A Prospective Study Of Coracoclavicular Ligament Reconstruction With Autogenous Peroneus Longus Tendon For Acromioclavicular Joint Dislocations

Purpose: Anatomic coracoclavicular ligament reconstruction(ACCR)provides good outcomes for Rockwood type III-VI acromioclavicular(AC)joint dislocations,and various grafts have been used,but complications from graft harvesting are not uncommon.The purpose of the present study was to examine the clinical and radiographic outcomes of patients with Rockwood type III to V AC joint dislocations repaired with ACCR using autogenous anterior half of the peroneus longus tendon(AHPLT)graft.Methods: Patients with bilateral anteroposterior(AP)and axillary radiographs indicating a Rockwood type III to V AC joint and magnetic resonance imaging(MRI)of the shoulder showing disruption of the CC ligaments(both the trapezoid and conoid ligaments),as well as the AC capsule,were eligible for ACCR using an autogenous AHPLT graft.Patients were evaluated clinically and radiographically preoperatively and at 1,3,6,and 12 months postoperatively.Outcome measures included Constant score(CS),visual analogue scale(VAS)pain score,and American Orthopedic Foot and Ankle Society(AOFAS)score.Factors such as age,sex,interval between trauma and surgery,VAS score,Rockwood type,and tunnel widening were examined using Spearman's rank correlation for their influence on Constance score and loss of reduction.Results: A total of 18 patients(15 men,3 women)with a mean age of 50.7 years(range,22–68 years)were included in the analysis.Of the 18 patients,15 completed clinical and radiographic follow-up examinations at 12 months.The mean preoperative CS was 51.1,and that at 12 months was 93.4(p < 0.005).At 12 months,no significant difference was noted between the CS of the injured and contralateral shoulder.The mean AOFAS score at 12 months was 99.3,and this was not different from the value at any other time point.Ten patients(56%)sustained a loss of reduction,and tunnel widening was observed in 9(50%),but neither was significantly correlated with functional outcome.Older patients were more likely to experience reduction loss.No donor site morbidity was noted after AHPLT harvesting.Conclusion: Autogenous AHPLT appears to be a reliable tendon graft sources for CC ligament reconstruction.