Posterior Distal Clavicle Beveling for Chronic Nonincarcerated Type IV Acromioclavicular Separations: Surgical Technique and Early Clinical Outcomes

• Published in: Arthroscopy Vol. 33; no. 1; pp. 84 - 89
• Main Authors: Buss, Daniel D., Anderson, Kelly, Tervola, Ned, Giveans, M. Russell
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.01.2017
• Subjects: Acromioclavicular Joint - diagnostic imaging; Acromioclavicular Joint - injuries; Acromioclavicular Joint - surgery; Adult; Arthroscopy - methods; Clavicle - surgery; Female; Humans; Injury Severity Score; Joint Dislocations - complications; Joint Dislocations - diagnostic imaging; Joint Dislocations - surgery; Ligaments, Articular - surgery; Male; Middle Aged; Orthopedics; Postoperative Period; Range of Motion, Articular; Retrospective Studies; Shoulder Pain - etiology; Surveys and Questionnaires; Treatment Outcome; Young Adult
• ISSN: 0749-8063; 1526-3231
• DOI: 10.1016/j.arthro.2016.06.013

To describe the arthroscopic partial posterior distal clavicle beveling technique for treatment of chronic nonincarcerated type IV acromioclavicular (AC) separations and report clinical outcomes and return to sport. All patients who underwent the arthroscopic partial distal clavicle beveling technique and met eligibility criteria were identified and retrospectively reviewed. Inclusion criteria included the clinical diagnosis of a chronic nonincarcerated type IV AC separation and a minimum follow-up period of 24 months. Subjects completed the American Shoulder Elbow Surgeons shoulder assessment and a study-designed questionnaire. Radiographic images and clinical charts were also reviewed. This study identified 15 consecutive patients with 2 lost to follow-up, resulting in inclusion of 13 subjects (9 males and 4 females). Dominant arm was involved in 77% of cases. Mean age at operation was 33.2 years (range, 19-56 years). The mean period between injury and operation was 12.5 months (range, 3-37 months), and follow-up was 48.5 months (range, 24-126 months). The mean preoperative ASES score was 46.6 ± 16.9 (range, 33-68), and the mean postoperative ASES score was 87.3 ± 17.4 (range, 50-100) (P < .0001). All 9 athletes in the study returned to competition with a mean recovery period of 2.3 months (range, 2 weeks to 4 months). Mean timeframe for return to work was 2 weeks (range, 1 day to 2 months). One subject underwent a subsequent coracoclavicular ligament reconstruction for continued pain. The mean satisfaction level was 4.3 out of 5, and 91% would choose to have the surgery again. One subject indicated dissatisfaction with shoulder appearance. The arthroscopic partial distal clavicle beveling procedure for nonincarcerated type IV AC separations resulted in a significant reduction in pain, improved daily function, and early return to sport. Level IV, therapeutic case series.