Summary

The use of a twin-tailed dog bone implant supplemented by internal brace of the AC joint creates a stable joint capable of return to collision sport at 8 weeks with comparable performance to pre-injury play.

Abstract

Objectives
The aim of the present study was to retrospectively review the results, return to sport and performance level after acromioclavicular joint stabilisation in a consecutive series of senior professional Australian Rules Football players competing in the Australian Football League (AFL).

Methods

Of 49 open ACJ stabilizations done over a 6 year period using a double fibretape and dog bone technique for ACJ stabilization after acute and subacute AC injuries (>/= Grade 3), 14 were performed in senior AFL players. After exclusions, a total of nine players could be included for analysis of post-operative success, return to high level collision sport, and performance scores in their first games after return to play. At a minimum follow-up of 12 months Nottingham Clavicle Score (NCS), Oxford Shoulder scoring System (OSS), Subjective Acromioclavicular Score (SACS) and Subjective Shoulder Value (SSV) were evaluated.

Results

At an average follow-up of 25.6 months (range 12 – 41) after surgery, mean NCS was 91.6 points (range 80 – 100), OSS was 47.3 points (range 42 – 48), SACS reached 99.9 points (range 99.8 – 100) and SSV was 94% (range 75 – 100), respectively. Average time of return to play was 60.6 days (8.7 weeks) for injuries that happened during the season. The game involvement (amount of kicks, marks, handballs and tackles) as well as player performance scores did not significantly change after surgery. However, the AFL Fantasy scores improved from 55.4 points before injury and surgery to 65.6 points after surgery (p = 0.08).

Conclusions

In a collective of professional Australian rules football players, an early return to collision sport after ACJ stabilisation could be achieved without clinical compromise. All athletes reached excellent clinical outcome scores and of the players with in-season injuries and available game statistics data, the post-operative performance scores were not negatively affected by return to play earlier than previously published.