Chronic acromio-clavicular dislocation: Bi-modal stabilization.

Abstract

Chronic acromio-clavicular dislocation is a challenging injury to treat. Many surgical procedures are available for its management which may be anatomical or non-anatomical. The aim of this study was to assess the clinical and radiological outcome in the patients with chronic acromio-clavicular dislocation treated by hybrid biological semitendinosus autograft and synthetic non-absorbable sutures. From July 2021 to January 2025, 21 patients with chronic acromio-clavicular dislocation were treated by hybrid biological semitendinosus autograft and synthetic non-absorbable sutures. Grade III to VI chronic acromio-clavicular injuries were included. Post-operatively, the patients were clinically assessed using Constant shoulder and Acromio-clavicular joint instability scores. Acromio-clavicular arthritis, coraco-clavicular ossification, distal clavicle osteolysis, coraco-clavicular and acromio-clavicular distances were radiologically evaluated. The mean age at time of surgery was 28.52 ± 8.0 (range: 19-45) years. The acromio-clavicular dislocation was type III in 7 patients (33.4 %), type IV in 12 patients ( %57.1) and type V in 2 patients (9.5 %). The mean follow-up period was 24.29 ± 3.51 (range: 18-30) months. The mean post-operative Acromio-clavicular joint instability and Constant shoulder scores were 93.14 ± 8.16 (range: 78-100) and 90.14 ± 8.16 (range: 80-100) points respectively. None of the patients showed recurrent dislocation, arthritis and distal clavicle osteolysis. Bi-modal stabilization using hybrid biological semitendinosus autograft and synthetic non-absorbable sutures is an effective and reliable surgical option to treat chronic acromio-clavicular dislocation. Most of the reported complications associated with this procedure didn't affect the functional outcome.