Operative treatment of acute acromioclavicular joint dislocation with anatomic reconstruction

Abstract

Introduction: The authors audited the outcomes of various surgical interventions employed to fix the dislocations of the acromioclavicular joint in their unit. This resulted in changing their method to treat this condition. Objective: Finding a technique that results in the best functional stability of the injured joint while preserving its physiological function. Method: In this particular area of traumatology, there is still uncertainty of the ideal way to provide the best outcome in terms of stability and function. From the currently known techniques, the authors have chosen the Minimally INvasive Acromioclavicular Joint Reconstruction (MINAR) method to be introduced in their unit. Its advantage is that it provides good stability combined with fast rehabilitation with a minimally invasive intervention. Furthermore, it is safe and easy to learn and master. It is also to be pointed out that it restores not only the stability but also the physiological functionality of the damaged joint. The authors carried out this type of operation first in 2012. They promoted the technique first in Hungary and became a ‘reference centre’ in the country. The authors will detail the method itself, both its indications and contraindications as well as the stages of the postoperative rehabilitation. Results: The authors scrutinized their results with imaging and 7 years of retrospective analysis with Constant and DASH scores. These were all in support of their choice of the MINAR method. Discussion: The authors concluded results congruent with international studies and recommendations. Additional analysis deducted aspects of the technique that could lead to further improvement in outcomes and highlighted areas for future study. Conclusion: In line with the recommendation of the European Shoulder Associates, the author’s recommendation is that the MINAR technique should be the first choice of intervention for dislocations of the acromioclavicular joint.