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Introduction Treatment of acute high-grade acromioclavicular joint (ACJ) injuries with metal-hardware alters the biomechanics of the ACJ, implying a second surgery for hardware removal. The period during which the plate is present involves functional limitations, pain and a risk factor for the development of hardware-related injuries. Arthroscopy-assisted procedures compared to open-metal-hardware techniques offer: less morbidity, the possibility to treat associated lesions and no need for a second operation. The aim was to compare the quality of life (QoL) of patients with acute high-grade ACJ injuries (Rockwood grade III–V), managed arthroscopically with a non-rigid coracoclavicular (CC) fixation versus the QoL of patients managed with a hook plate, 24 months or more after their shoulder injury. Patients and methods A retrospective revision of high-grade ACJ injuries managed in three institutions was performed. Patients treated by means of an arthroscopy-assisted CC fixation or by means of a hook plate were included. The inclusion period was between 2008 and 2012. The QoL was evaluated at the last follow-up visit by means of the SF36, the visual analog scale (VAS), the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, the Constant score and the global satisfaction (scale from 0 to 10). The presence of scapular dyskinesis and remaining vertical instability were evaluated. Comparison between groups was performed. Results Thirty-one patients were included: 20 arthroscopy group (ARTH group: 3 Rockwood III, 3 IV and 14 V) and 11 hook plate group (HOOK group: 5 Rockwood III and 6 V). The mean age was 36 [25–52] years old for the ARTH group and 41 [19–55] for the HOOK group (P = 0.185). The mean results of the questionnaires were: (1) physical SF36 score (ARTH group 58.24 ± 2.16 and HOOK group 53.70 ± 4.33, P Conclusion Patients with acute high-grade ACJ injuries managed arthroscopically with a non-rigid CC fixation seem to have a better QoL than patients managed with a hook plate. Level of evidence Level IV. Therapeutic; retrospective comparative study. |
