Journal of Orthopaedic Surgery 2015;23(2):223-8

Jonathan Wright, Donald Osarumwense, Fikry Ismail, Yvonne Umebuani, Samuel Orakwer

Queen Elizabeth Hospital, Woolwich, London, United Kingdom

This paper reports outcomes of 21 men who underwent stabilisation for the disrupted ACJ using the Lockdown device.

12 men had Rockwood Type III, 1 man had Rockwood Type IV, and 8 men had Rockwood Type V.

The patients with type III ACJ injury had undergone 3 months of conservative treatment and physiotherapy; one of the patients opted for surgery after one month.  Two patients with type V injury had delayed surgery; one had delayed referral and another opted to avoid surgery initially.

The postoperative protocol involved 4 weeks of immobilisation in a sling followed by physiotherapist guided mobilisation with an aim to restart light activities at 8 weeks and return to sports at 12 weeks.

Outcomes were assessed using the Constant and Oxford Shoulder Score.

The meantime between injury and surgery was 6.8 months.  The mean follow-up duration was 30 months. The mean Constant Score was 86.8 (range 62-100) and the mean Oxford Shoulder Score was 43.1 (range 28.48.

20 patients were satisfied with the procedure. One patient was dissatisfied as he developed scapulothoracic bursitis.  One patient required arthroscopic subacromial decompression for impingement.  One patient sustained a redislocation following a fall at 6 weeks and declined further surgery.  None of the patients encountered infection or fracture of the clavicular / coracoid process or required removal of the implant because of irritation.

The paper concludes that the Lockdown™ device achieves good outcomes for patients undergoing stabilisation for the disrupted ACJ.

You can access the full paper here.