Title : Mid-term functional outcomes following lockdown™ ligament reconstruction for rockwood type III Acromioclavicular Joint (ACJ) disruption
Abstract:
Background: The optimal management of Rockwood type III acromioclavicular joint (ACJ) dislocations remains controversial. Synthetic ligament reconstruction using the LockDown™ (Surgilig®) ligament has gained popularity because of its biomechanical strength and favourable early outcomes; however, evidence regarding medium- to long-term functional results remains limited. This study evaluated the mid-term clinical and functional outcomes following LockDown™ ligament reconstruction for type III ACJ disruption.
Methods: A retrospective cohort study was performed of patients undergoing primary LockDown™ ligament reconstruction for Rockwood type III ACJ disruption between November 2013 and June 2018. Patients aged under 18 years, revision procedures, and those with associated glenoid, proximal humeral or neurovascular injuries were excluded. All procedures were performed by two senior shoulder surgeons using a standardised surgical technique followed by a uniform rehabilitation protocol. Primary outcomes were Oxford Shoulder Score (OSS) and University of California Los Angeles (UCLA) Shoulder Score. Secondary outcomes included patient satisfaction, return to work, return to sport, and postoperative complications.
Results: Eleven patients were available for final analysis, with a mean age of 43.4 years and a mean follow-up of 66.3 months (range 51–90 months). The cohort was predominantly male (77%). Excellent functional outcomes were achieved in 81.8% of patients according to the Oxford Shoulder Score and 63.6% according to the UCLA Shoulder Score. Overall, 81.8% of patients reported being very satisfied with their surgical outcome, and all participants stated they would choose to undergo the procedure again. Mean time to return to work was 120 days, while return to sport occurred at a mean of 157.5 days. One patient developed clinically insignificant heterotopic ossification. One patient died from postoperative sepsis requiring implant removal; this patient had significant medical comorbidities. No cases of ligament rupture or mechanical failure were observed during follow-up.
Conclusion: LockDown™ ligament reconstruction for Rockwood type III ACJ disruption demonstrates excellent mid-term functional outcomes, high patient satisfaction, and durable construct integrity at more than five years' follow-up. Although complications were uncommon, careful patient selection remains essential. Larger prospective studies are required to further establish the long-term efficacy and safety of this technique.
