scholarly journals Clinical and Radiographic Outcomes of 3D Printed Total Talus Arthroplasty

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0037
Author(s):  
Daniel Scott ◽  
John Steele ◽  
Amanda Fletcher ◽  
Selene Parekh
Keyword(s):  
Avascular Necrosis ◽  
Weight Bearing ◽  
Treatment Options ◽  
Ankle Motion ◽  
Motion Data ◽  
Radiographic Outcomes ◽  
Significant Difference ◽  
3D Printed ◽  
Vas Scores

Category: Ankle, Ankle Arthritis, Hindfoot, Trauma Introduction/Purpose: Patients with talar avascular necrosis have limited treatment options to manage their symptoms. Historically, surgical options have been limited and can leave patients with little ankle motion and have high failure rates. The use of custom 3D printed total talar replacements (TTR) has arisen as a treatment option for these patients, possibly allowing for better preservation of hind-foot motion. Patients undergoing TTR will demonstrate a statistically significant improvement in FAOS scores at one year after surgery. Methods: We retrospectively reviewed 15 patients who underwent a TTR over 2 years. Patient outcomes were reviewed including age, sex, comorbidities, etiology of talar pathology, number and type of prior surgeries, pre-operative and post-operative weight bearing radiographs, as well as FAOS and VAS scores, and range of motion. Data analysis performed with student T-test and multivariate regression. Results: Results: FAOS scores showed statistically significant improvements post-operatively as compared to pre-operative scores. There was a statistically significant decrease in VAS pain scores from 7.0 pre-operatively to 3.4 post operatively. There was no significant difference in pre-operative and post-operative coronal and sagittal alignment on weight bearing radiographs. All FAOS sub-score shows statistically significant improvements, with the exception of the sports/recreation sub-scale, did show a trend towards improved outcomes (p =0.19). Average follow-up was 12.8 months. Conclusion: Our hypothesis was confirmed that these patients show statistically significant improvements in AOFS and VAS scores at 1 year. Sagittal and coronal alignment was well maintained at an average of 1 year following surgery. TTR represents an exciting treatment options for patients with talar avascular necrosis, though longer-term follow-up is needed.

scholarly journals Outcomes following 3D Printed Total Talus Arthroplasty

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0041 ◽  
Author(s):  
Daniel Scott ◽  
Selene Parekh
Keyword(s):  
Avascular Necrosis ◽  
Treatment Options ◽  
Ankle Motion ◽  
Pain Scores ◽  
Foot Motion ◽  
3D Printed ◽  
Vas Scores ◽  
Hind Foot ◽  
Joint Arthritis

Category: Hindfoot Introduction/Purpose: Many patients with talar avascular necrosis have limited treatment options to manage their symptoms. Historically, surgical options have included pan-talar fusions, tibio-talar-calcaneal fusions, and revascularization procedures. Unfortunately, these treatment options can leave patients with little ankle and hind-foot motion, can increase adjacent joint arthritis, and have significant failure rates. Recently, the use of custom 3D printed total talar replacements has arisen as a treatment option for these patients. Theoretically, this allows for better preservation of hind-foot motion as well as possibly less adjacent joint arthritis. Methods: We retrospectively reviewed 15 patients who underwent a 3D printed total talus replacement by a single surgeon over 2 years. Each patient had pre-operative CT scans of both the affected and non-affected talus. Custom 3D printed implants were made in two sizes based on templating performed on the contralateral talus. All total talus replacements were performed through a direct anterior approach. Patient outcomes were reviewed pre and post-operatively including age, sex, comorbidities, etiology of talar pathology, number and type of prior surgeries, as well as VAS scores, range of motion, and number of additional or subsequent procedures. Results: The average patient age was 45. 6/15 patients had previously undergone surgery on the ipsilateral hind-foot/ankle. There was a statistically significant decrease in VAS pain scores from 7.0 pre-operatively to 2.5 at final follow up. There was a statistically significant increase in both ankle and sub-talar motion at final follow up when compared to pre-op. Average follow-up was 8.4 months, with a minimum follow up of 3 months. Of the four patients with 1 year or longer follow up (average 13.3 months), VAS scores and ROM were similar to patients with shorter follow up duration. 3 patients had concomitant procedures, most commonly tendo-achillies lengthening. One patient required an additional procedure (incision and drainage) for treatment of wound dehiscence. Conclusion: 3D printed total talus replacements represent an exciting treatment options for patients with significant talar avascular necrosis. At early follow up, patients showed good improvement in VAS pain scores and actually improved their hindfoot and ankle motion. Certainly, longer term follow-up will be needed to evaluate the longevity of these implants. However, these implants represent an intriguing option for patients that lack an ideal surgical solution and show promise at very early follow up.

Early Outcomes of 3D Printed Total Talus Arthroplasty

2019 ◽  
Vol 13 (5) ◽  
pp. 372-377 ◽  
Author(s):  
Daniel J. Scott ◽  
John Steele ◽  
Amanda Fletcher ◽  
Selene G. Parekh
Keyword(s):  
Treatment Option ◽  
Treatment Options ◽  
Case Series ◽  
Level Of Evidence ◽  
Ankle Motion ◽  
Motion Data ◽  
Number Of Patients ◽  
3D Printed ◽  
Radiographic Alignment

Background. Patients with talar avascular necrosis (AVN) have limited treatment options to manage their symptoms. Historically, surgical options have been limited and can leave patients with little ankle motion and have high failure rates. The use of custom 3D printed total talar replacements (TTRs) has arisen as a treatment option for these patients, possibly allowing better preservation of hindfoot motion. We hypothesized that patients undergoing TTR will demonstrate a statistically significant improvement in Foot and Ankle Outcome Score (FAOS) at 1 year after surgery. Methods. We retrospectively reviewed 15 patients who underwent a TTR over a 2-year period. Patient outcomes were reviewed, including age, sex, comorbidities, etiology of talar pathology, number and type of prior surgeries, radiographic alignment, FAOS and Visual Analog Scale (VAS) score, and range of motion. Data analysis was performed with Student t-tests and multivariate regression. Results. FAOSs and VAS scores showed statistically significant improvements postoperatively as compared with preoperative scores. There was a statistically significant decrease in VAS pain scores from 7.0 preoperatively to 3.6 (P < .001). Average follow-up was 12.8 months. With the number of patients available, there was no statistically significant change in radiographic alignment parameters postoperatively as compared with preoperatively (P values ranged from .225 to .617). Conclusion. Our hypothesis that these patients show statistically significant improvements in FAOSs at 1 year was confirmed. TTR represents an exciting treatment option for patients with talar AVN, though longer-term follow-up is needed. Level of Evidence: Level IV: Case series

scholarly journals Impact of Early Weight-Bearing Following Ankle Arthroscopy and Microfracture of Talar Osteochondral Defects

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0027
Author(s):  
Thomas Lefebvre ◽  
Daniel J. Scott ◽  
Jonathan Peterson ◽  
Samuel Adams ◽  
Annunziato Amendola
Keyword(s):  
Range Of Motion ◽  
Weight Bearing ◽  
Ankle Arthroscopy ◽  
Full Weight Bearing ◽  
Osteochondral Defects ◽  
Foot And Ankle ◽  
Ankle Impingement ◽  
Significant Difference ◽  
Vas Scores

Category: Arthroscopy Introduction/Purpose: Ankle impingement and ankle osteochondral defects are common problems seen by foot and ankle specialist that often go on to require surgical managment. After conservative treatment fails, ankle impingement is often managed by arthroscopic debridement, whereas ankle OCDs are often treated with ankle arthroscopy and microfracture as a first line treatment. However, surgeons have various treatment protocols post-operatively after these procedures, with some surgeons allowing immediate weight bearing, were as other surgeons restrict patients weight bearing. There is similar heterogeneity in the manner of immobilization post-operatively. The purpose of this study is to retrospectively review the outcomes of patients undergoing ankle arthroscopy and micro fracture, to determine if immediate weight bearing or removable immobilization had any impact on outcomes. Methods: We retrospectively reviewed 79 patients at our institution who underwent ankle arthroscopy with microfracture for talar osteochondral defects over 3 years. This included surgeries performed by one of 7 fellowship trained foot and ankle surgeons at our institution. Each surgeon had different protocols for post-operative weight bearing and immobilization, allowing for a comparison of various post-operative protocols. Patient outcomes were reviewed pre-operatively and post-operatively including age, sex, comorbidities, etiology of talar pathology, post-operative weight bearing status, time to first weight bearing, as well as method and length of immobilization, VAS scores, range of motion, and complications. Clinical outcomes such as time to return to work and return to sport were also evaluated. Results: The average patient age was 38. 42 patients (53%) had an additional procedure performed at the time of ankle arthroscopy and microfracture. There was no significant difference in the average pre-op and post-op VAS or range of motion between the immediate weight bearing group and the delayed weight bearing group. There was interestingly a trend towards lower VAS scores in the immediate weight bearing group (1.4 vs 2.6). Conclusion: Following ankle arthroscopy and microfracture, we found no difference in VAS, range of motion, or complications when allowing immediate, full weight bearing as well as using removable immobilization as compared to a variety of other protocols at early follow up. In fact, there was a trend towards lower VAS scores in the immediate full weight bearing group. Though this study has early follow up, it does suggest at least the equivalency of allowing immediate weight bearing and removable immobilization following ankle arthroscopy and talar microfracture.

scholarly journals Radiofrequency Microtenotomy or Physical Therapy for Achilles Tendinopathy: Results of a Randomized Clinical Trial

2021 ◽  
Vol 9 (12) ◽  
pp. 232596712110625
Author(s):  
Zeiad Al-Ani ◽  
Dana Meknas ◽  
Jüri-Toomas Kartus ◽  
Øyvind Lyngedal ◽  
Khaled Meknas
Keyword(s):  
Physical Therapy ◽  
Controlled Trial ◽  
Treatment Options ◽  
Randomized Study ◽  
Achilles Tendinopathy ◽  
Level Of Evidence ◽  
Bipolar Radiofrequency ◽  
Significant Difference ◽  
Vas Scores

Background: Achilles tendinopathy is a painful disorder, and various treatment options are available. Bipolar radiofrequency microtenotomy (RFM) has shown promising results in treating tendinosis. Purpose/Hypothesis: The purpose was to compare the results between treatment with bipolar RFM and physical therapy (PT) for patients with midportion Achilles tendinopathy. It was hypothesized that RFM would be equivalent or superior to PT. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A total of 38 patients with midportion Achilles tendinopathy were evaluated for 2 years. The patients were randomized to receive either RFM or PT. There were 20 patients in the RFM group and 18 patients in the PT group. Clinical outcomes were assessed using the visual analog scale (VAS) for pain and the Foot and Ankle Outcome Score (FAOS). The degree of tendinosis was evaluated with magnetic resonance imaging (MRI) of the affected ankle performed before intervention and 2 years after intervention. Results: In both groups, the VAS scores at the 2-year follow-up were significantly improved compared with preintervention: from 7.2 ± 1.5 to 1.0 ± 1.4 for the RFM group and from 5.9 ± 1.3 to 3.1 ± 1.8 for the PT group ( P < .01 for both). Compared with the PT group, the RFM group had significantly better VAS scores at both the 1- and 2-year follow-ups ( P < .01 for both) and better scores on 4 of the 5 FAOS subscales at the 2-year follow-up ( P < .01 for all). MRI revealed an improvement in the tendinosis score in both groups, without any significant difference between the groups. Conclusion: In this randomized study, the clinical assessments revealed significant improvements in the VAS, FAOS, and tendinosis score as seen on MRI 2 years after intervention with either RFM or PT in patients with midportion Achilles tendinopathy. The improvement was significantly better in the RFM group with regard to VAS and FAOS, but not in the MRI appearance. Registration: NCT03274557 ( ClinicalTrials.gov identifier).

scholarly journals The radiological outcome in lumbar interbody fusion among rheumatoid arthritis patients: a 20-year retrospective study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Kuan-Kai Tung ◽  
Yun-Che Wu ◽  
Kun-Hui Chen ◽  
Chien-Chou Pan ◽  
Wen-Xian Lu ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Interbody Fusion ◽  
Fusion Rate ◽  
Substantial Improvement ◽  
Lumbar Interbody Fusion ◽  
Subsidence Rate ◽  
Radiographic Outcomes ◽  
Significant Difference ◽  
Cage Subsidence

Abstract Background Clinical outcomes amongst Rheumatoid Arthritis (RA) patients have shown satisfactory results being reported after lumbar surgery. The increased adoption of the interbody fusion technique has been due to a high fusion rate and less invasive procedures. However, the radiographic outcome for RA patients after receiving interbody fusion has scarcely been addressed in the available literature. Methods Patients receiving interbody fusion including ALIF, OLIF, and TLIF were examined for implant cage motion and fusion status at two-year follow-up. Parameters for the index correction level including ADH, PDH, WI, SL, FW, and FH were measured and compared at pre-OP, post-OP, and two-year follow-up. Results We enrolled 64 RA patients at 104 levels (mean 64.0 years old, 85.9% female) received lumbar interbody fusion. There were substantial improvement in ADH, PDH, WI, SL, FW, and FH after surgery, with both ADH and PDH having significantly dropped at two-year follow up. The OLIF group suffered from a higher subsidence rate with no significant difference in fusion rate when compared to TLIF. The fusion rate and subsidence rate for all RA patients was 90.4 and 28.8%, respectively. Conclusions We revealed the radiographic outcomes of lumbar interbody fusions towards symptomatic lumbar disease in RA patients with good fusion outcome despite the relative high subsidence rate amongst the OLIF group. Those responsible for intra-operative endplate management should be more cautious to avoid post-OP cage subsidence.

scholarly journals Extracorporeal shockwave therapy versus musculoskeletal mesotherapy for Achilles tendinopathy in athlete

2020 ◽  
Vol 47 (1) ◽  
Author(s):  
Reem EL-Mallah ◽  
Enas A. Elattar
Keyword(s):  
Treatment Options ◽  
Visual Analogue Score ◽  
Achilles Tendinopathy ◽  
Extracorporeal Shockwave Therapy ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy ◽  
Tendon Thickness ◽  
Vas Scores ◽  
Tendon Pathology

Abstract Background Achilles tendinopathy (AT) is considered the commonest tendon pathology, occurring mainly in athletes. Different conservative treatment options have been introduced but with short-term effects; however, extracorporeal shockwave therapy (ESWT) and mesotherapy (MT) injections were claimed to provide longer effects and could be used in cases failure of response to conservative treatments. The objective of our prospective 12-week study was to compare the effect of ESWT and MT on chronic Achilles tendinopathy in athletes by both clinical and ultrasonographical assessment. Results Forty patients with chronic AT diagnosed clinically and with high-resolution ultrasound (US) randomly allocated in two groups first received weekly ESWT session, and the other group underwent weekly MT sessions for 4 consecutive weeks. Both groups improved during the treatment and follow-up period. The mean visual analogue score (VAS) decreased in both the ESWT group and the MT group. Mean American Orthopedic Foot and Ankle Society (AOFAS) hindfoot score and VAS scores were not significantly different between ESWT and MT groups at the 4th and the 12th week of follow-up. However, US assessment significantly improved after 12 weeks in the ESWT group (as regards tendon thickness, calcifications, and Doppler signal), and for the mesotherapy group, there was the only improvement of tendon thickness. Conclusion ESWT showed improvement of pain and inflammation and calcifications of AT than MT injections, which was documented by US improved findings at week 12 follow up.

No Difference in Outcomes Following Osteochondral Allograft with Fresh Precut Cores Compared to Hemi-Condylar Allografts

Cartilage ◽  
2021 ◽  
pp. 194760352110219
Author(s):  
Danielle H. Markus ◽  
Anna M. Blaeser ◽  
Eoghan T. Hurley ◽  
Brian J. Mannino ◽  
Kirk A. Campbell ◽  
...  
Keyword(s):  
Patient Reported Outcomes ◽  
Knee Injury ◽  
Lesion Size ◽  
Osteochondral Allograft ◽  
Osteochondral Lesions ◽  
Radiographic Outcomes ◽  
Significant Difference ◽  
Patient Reported ◽  
The Mean

Objective The purpose of the current study is to evaluate the clinical and radiographic outcomes at early to midterm follow-up between fresh precut cores versus hemi-condylar osteochondral allograft (OCAs) in the treatment of symptomatic osteochondral lesions. Design A retrospective review of patients who underwent an OCA was performed. Patient matching between those with OCA harvested from an allograft condyle/patella or a fresh precut allograft core was performed to generate 2 comparable groups. The cartilage at the graft site was assessed with use of a modified Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) scoring system and patient-reported outcomes were collected. Results Overall, 52 total patients who underwent OCA with either fresh precut OCA cores ( n = 26) and hemi-condylar OCA ( n = 26) were pair matched at a mean follow-up of 34.0 months (range 12 months to 99 months). The mean ages were 31.5 ± 10.7 for fresh precut cores and 30.9 ± 9.8 for hemi-condylar ( P = 0.673). Males accounted for 36.4% of the overall cohort, and the mean lesion size for fresh precut OCA core was 19.6 mm2 compared to 21.2 mm2 for whole condyle ( P = 0.178). There was no significant difference in patient-reported outcomes including Visual Analogue Scale, Knee Injury and Osteoarthritis Outcome Score for Joint Replacement, and Tegner ( P > 0.5 for each), or in MOCART score (69.2 vs. 68.3, P = 0.93). Conclusions This study found that there was no difference in patient-reported clinical outcomes or MOCART scores following OCA implantation using fresh precut OCA cores or size matched condylar grafts at early to midterm follow-up.

scholarly journals Radiographic Recurrence of Hallux Valgus Based on Osteotomy Location

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0021
Author(s):  
Andrew Federer ◽  
Travis Dekker ◽  
David Tainter ◽  
Jordan Liles ◽  
Mark Easley ◽  
...  
Keyword(s):  
Hallux Valgus ◽  
Weight Bearing ◽  
Surgical Correction ◽  
P Value ◽  
Single Individual ◽  
Hallux Valgus Angle ◽  
Intermetatarsal Angle ◽  
Valgus Angle ◽  
Significant Difference

Category: Bunion Introduction/Purpose: Hallux valgus (HV) is one of the most common deformities of the foot resulting in pain and lifestyle modification of the patient. Recurrence rates of 10-47% have been documented in single individual osteotomy series. Unfortunately, surgical correction and recurrence are often defined as changes related to normal radiographs and not actually as the magnitude of correction lost with follow-up. Currently there have not been studies evaluating the percentage of recurrence of intermetatarsal angle (IMA) and hallux valgus angle (HVA). As there is substantial difference in starting IMA and HVA, as well as amount of surgical correction, our goal was to evaluate the percentage loss of correction over time comparing preoperative, initial postoperative and minimum of 2-year follow up radiographs among three different surgical correction techniques. Methods: This is a retrospective chart review study that examines the weight-bearing radiographic measurements of patients undergoing hallux valgus corrective surgery at a single institution over 5 years. Fifty-three patients were divided into first tarsometatarsal arthrodesis (i.e. Lapidus), mid-diaphyseal osteotomies (i.e. scarf), and distal metatarsal osteotomies (i.e. chevron). The preoperative, initial postoperative, and final follow up weight-bearing radiographs were measured for intermetatarsal angle (IMA) and hallux valgus angle (HVA). Primary outcome was percentage of recurrence of IMA and HVA, with the difference in angles between preoperative and initial postoperative weight-bearing films being considered 100% correction. The percentage of recurrence between initial postoperative and most recent follow up was then calculated (Figure 1A). A one-way analysis of variance (ANOVA) test and post-hoc Tukey-Kramer tests were used to compare preoperative IMA and HVA and percentage recurrence of IMA and HVA at most recent follow up. Results: There was no significant difference between Lapidus (14.3deg) and mid-diaphyseal osteotomies (12.7deg) in preoperative IMA (p-value=0.26). There was a significant difference between Lapidus (-0.3deg) and mid-diaphyseal (2.8deg) osteotomies for degree of hallux valgus recurrence as measured by IMA between initial postoperative films and final 2-year follow up (p-value=0.009). Lapidus procedure showed a greater magnitude decrease in IMA degrees from preoperation to final follow up compared to distal osteotomy (p-value=0.037) and trended toward significance compared to mid-diaphyseal (p-value=0.056). Mid-diaphyseal osteotomies (30%) showed a statistically significant higher percentage of IMA recurrence compared to Lapidus (-11%) (p-value=0.0014) (Figure 1B). When comparing percentage recurrence of HVA, distal osteotomies had a significantly smaller rate of recurrence when compared to the diaphyseal osteotomies (p-value=0.030). Conclusion: Though Lapidus and mid-diaphyseal osteotomies were performed for patients with a similar preoperative IMA, mid-diaphyseal osteotomies had a significantly higher percentage of recurrence at 2-year follow up compared to Lapidus procedures. Moreover, Lapidus procedures trended toward greater overall of IMA correction compared to mid-diaphyseal osteotomies. When either a Lapidus or mid-diaphyseal osteotomy is indicated, a Lapidus procedure may result in decreased rate of radiographic recurrence of hallux valgus at 2 years.

CLINICAL AND RADIOLOGIC OUTCOMES OF TWO TYPES OF CAGES USED IN THE TREATMENT OF DEGENERATIVE LUMBAR DISEASES: NOVEL TITANIUM CAGES VERSUS PEEK CAGES

2020 ◽  
Vol 23 (01) ◽  
pp. 2050004
Author(s):  
Meng-Yin Yang ◽  
Hsin-Huan Chang ◽  
Shao-Ching Chao
Keyword(s):  
Transforaminal Lumbar Interbody Fusion ◽  
Neurological Status ◽  
Clinical Effects ◽  
Disc Disease ◽  
Degenerative Lumbar Diseases ◽  
Intervertebral Disc Height ◽  
Significant Difference ◽  
Vas Scores ◽  
Titanium Cages

Purpose: This study reports the clinical effects of [Formula: see text]-shaped titanium cages (ReBorn Essence Z-Brace cages) and compares the clinical outcomes between [Formula: see text]-shaped titanium cages (ZTC group) and polyetheretherketone cages (PEEK cages, PK group) for the application in transforaminal lumbar interbody fusion (TLIF). Methods: A retrospective and case control study with six patients using PEEK cages and four patients using ZTC was conducted. All patients underwent TLIF and had a 3-month follow-up. The Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) were selected to assess the pain of low back and neurological status. The intervertebral disc height (DH) and segmental angle (SA) were also measured to estimate the radiological changes. At the 3-month follow-up, the fusion and subsidence rates were evaluated. Results: There was no significant difference between the two groups regarding the ODI and VAS scores. At the 3-month follow-up, the subsidence rates were 42% and 0% for the PK and ZTC groups, respectively; the bony fusion rates were 67% and 100% for the PK and ZTC groups, respectively. Conclusion: The study has indicated that both PEEK and [Formula: see text]-shaped titanium cages can be effective options used to treat degenerative disc disease (DDD). Moreover, the higher fusion and lower subsidence rates have revealed that [Formula: see text]-shaped titanium cages may be a better choice compared to PEEK cages for lumbar reconstruction after TLIF.

scholarly journals Functional and Radiographic Outcomes After Anatomic Coracoclavicular Ligament Reconstruction for Type III/V Acromioclavicular Joint Injuries

2019 ◽  
Vol 7 (11) ◽  
pp. 232596711988453 ◽  
Author(s):  
Lukas N. Muench ◽  
Cameron Kia ◽  
Aulon Jerliu ◽  
Matthew Murphy ◽  
Daniel P. Berthold ◽  
...  
Keyword(s):  
Ligament Reconstruction ◽  
Coracoclavicular Ligament ◽  
Ac Joint ◽  
Type Iii ◽  
Radiographic Outcomes ◽  
Joint Injuries ◽  
Coracoclavicular Ligament Reconstruction ◽  
Significant Difference ◽  
Ac Joint Injuries

Background: Acromioclavicular (AC) joint separation is a common injury. The anatomic coracoclavicular ligament reconstruction (ACCR) technique is a viable treatment option, designed to restore the native joint anatomy. Purpose: To evaluate the clinical and radiographic outcomes of patients undergoing ACCR for the treatment of type III and V AC joint injuries with a minimum 2-year follow-up. Study Design: Case series; Level of evidence, 4. Methods: A retrospective chart review was performed on prospectively collected data. Patients who underwent ACCR for type III or V AC joint injuries between January 2003 and December 2015 were analyzed. Clinical outcome measures included the American Shoulder and Elbow Surgeons (ASES) score, Rowe score, Simple Shoulder Test (SST), and Constant-Murley (CM) score. To determine the clinical relevance of the ASES score, the minimal clinically important difference (MCID), substantial clinical benefit (SCB), and patient acceptable symptomatic state (PASS) were used. The pre- and postoperative coracoclavicular distance (CCD) and side-to-side difference in the CCD were measured for radiographic analysis. Results: A total of 43 patients (22 acute, 21 chronic) were included in the study. The mean patient age was 43.4 ± 11.4 years, with a mean follow-up of 3.4 years (range, 2.0-7.5 years). With regard to the ASES score, 92% of patients achieved the MCID, 81% achieved the SCB, and 49% reached or exceeded the PASS. There was no significant difference when stratifying by type (III vs V) or chronicity (acute vs chronic) of injury (both P > .05). The Rowe score improved from 66.6 ± 15.9 preoperatively to 88.6 ± 12.3 postoperatively, the CM score from 61.6 ± 18.8 to 87.4 ± 15.1, and the SST score from 6.2 ± 3.6 to 9.4 ± 3.7 (all P < .001). The postoperative side-to-side difference in the CCD was 3.1 ± 2.7 mm, with type III injuries (2.4 ± 1.9 mm) showing significantly lower measurements compared with type V (4.2 ± 3.4 mm) ( P = .02). No significant trend was found between joint reduction and the improvement in clinical outcomes ( P > .05). Conclusion: Patients undergoing ACCR for acute and chronic type III and V AC joint injuries maintained significant improvement in clinical and radiographic outcomes at a minimum 2-year follow-up. Additionally, 81% of patients reached the SCB after surgical reconstruction.

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