Subsidence following surgical stabilization of acromioclavicular joint injuries: Should we be concerned?

Table 2 Loss of reduction rates following modified Weaver-Dunn procedures and anatomic coracoclavicular ligament reconstructions

Ref.	Study design	n	Rockwood type	Technique	Mean follow-up	LOR/re-dislocation
Hegazy et al[67], 2016	Prospective	20 (10 vs 10)	Chronic (III)	Reconstruction by semitendinosus autograft vs modified WD	27.8 months	ST graft: 0%; WD: 30% early failures
Kibler et al[69], 2017	Retrospective	15	Acute and chronic (III-V)	Reconstruction with allograft + AC ligament docking	36 months	7%
Kumar et al[70], 2014	Retrospective	55 (31 vs 24)	Chronic (III-V)	Reconstruction by synthetic ligament vs Modified WD + CC sling	40 months	WD: 9.7%; synthetic ligament: 4.2% with rupture
Fauci et al[68], 2013	RCT	40 (20 vs 20)	Chronic (III, IV)	Reconstruction by biological allograft vs synthetic ligament	4 years	Biologic: 5% LOR, 5% subluxation; synthetic: 10% LOR, 30% subluxations
Boström Windhamre et al[72], 2010	Retrospective	45 (23 vs 22)	Chronic (III-V)	WD augmented with hook plate vs with PDS-braid fixation	7-9 years	Hook plate: 17.4%; PDS-braid: 13.6%
Millett et al[71], 2009	Prospective	17	Acute and chronic (IV-V)	Coracoacromial ligament transfer using docking technique (modified WD)	29 months	6% re-dislocation after trauma
Tauber et al[75], 2009	Prospective	24 (12 vs 12)	Chronic (III-V)	Reconstruction by semitendinosus autograft vs modified WD	37 months	WD: 41.7%; ST graft: 8.3%
Law et al[73], 2007	Retrospective	5	Acute (III)	Reconstruction by gracilis tendon autograft	26 months	20% subluxation
Pavlik et al[74], 2001	Retrospective	17	Chronic (III)	Modified WD + CC screw	36.6 months	Slight loss: 35%; partial loss: 12%

LOR: Loss of reduction; RCT: Randomized controlled trial; WD: Weaver-Dunn; AC: Acromioclavicular; CC: Coracoclavicular; PDS: Polydioxanone suture; ST: Semitendinosus tendon.