Timing of Surgical Treatment for High-Grade Acromioclavicular Joint Injuries Does Not Affect Functional Outcomes

Q3 Medicine Arthroscopy Sports Medicine and Rehabilitation Pub Date : 2025-02-01 DOI:10.1016/j.asmr.2024.101017

Ryan W. Paul B.S. , Nathaniel Tchangou B.S. , Krysten Floyd B.S. , Matthew Sabitsky B.S. , Gregory Connors B.S. , Bryson Kemler M.D. , John Hayden Sonnier M.D. , Fotios P. Tjoumakaris M.D. , Kevin B. Freedman M.D.

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Abstract

Purpose

To determine, using multivariate regression, whether patient-reported outcomes are associated with surgical timing to account for differences between groups.

Methods

Patients who underwent acromioclavicular (AC) joint surgery from 2010 to 2019 were included if they underwent primary AC joint surgery for a Rockwood grade III-V AC joint separation. Chart review was conducted to determine time from injury to surgery, Rockwood injury grade, and surgical technique. Postoperative complications, revisions, American Shoulder and Elbow Surgeons (ASES) score, Single Assessment Numeric Evaluation (SANE) scores, and radiographic outcomes were collected. Radiographic outcomes were determined by measuring coracoclavicular (CC) distance on preoperative, immediate postoperative, and all follow-up anterior-posterior views of the operative shoulder. Multivariate regressions were conducted with postoperative ASES, SANE, and CC distance as the outcomes of interest.

Results

Overall, 221 patients (104 early, 117 delayed) with an average age of 40 ± 15 years were included in this study. Significant differences in patient age, body mass index, injury grade, surgical technique used, and preoperative CC distance were observed between groups (all P < .05). After we controlled for confounding variables such as age, sex, body mass index, injury grade, and surgical technique, multivariate regression found that time from injury to surgery was not related to postoperative ASES score (R² = 0.137, P = .563) or postoperative SANE score (R² = 0.087, P = .441). Female patients had lower ASES scores than male patients (estimate: −8.25, 95% confidence interval −15.99 to −0.050, P = .039); however, no other significant relationships were identified from multivariate regression.