Delayed ACJ Reconstruction Does Not Increase the Risk of Fixation Failure or Major Complications

Description

In this presentation, Hattie Pleasant, a medical student at the University of Edinburgh, discusses her research project on the outcomes of delayed versus early reconstruction of the acromioclavicular joint (ACJ). The study indicates that delayed ACJ reconstruction using modern suspensory devices does not increase the risk of fixation failure or major complications compared to early fixation. Hattie highlights the traditional view favoring early intervention but cites a systematic review suggesting that previous complications were linked to outdated surgical techniques.



She explains the study's aims, which include comparing complication rates and modes of failure in patients undergoing either early (less than 12 weeks post-injury) or delayed (more than 12 weeks post-injury) surgical treatment at a tertiary center in Edinburgh, focusing on patients with Rockwood grade III, IV, or V injuries from 2010 to 2020. The research found no significant differences in major complications or functional outcomes, suggesting that delayed surgery is a viable option without higher risks.



Hattie also cites four failure modes identified during the study and discusses the need for further trials on nonoperative management for patients who may not need immediate surgical intervention. The presentation concludes with Hattie welcoming questions and addressing concerns regarding the surgical approach to ACJ injuries.

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