Journal of Clinical Medicine
Clinical, Radiographic, and Return-to-Sport Outcomes After MINAR Reconstruction for Acute High-Grade Acromioclavicular Joint Separation in Recreational Football Players
By Aydoğan Aşkın, Vugar Nabi Nabiyev, Fatih Duygun and 5 others.
Abstract
Background
High-grade acromioclavicular (AC) joint separations are clinically relevant injuries in contact sports, yet data specific to recreational football players remain limited. This study evaluated clinical recovery, maintenance of vertical coracoclavicular reduction, and return-to-sport outcomes after minimally invasive acromioclavicular reconstruction (MINAR) in recreational players with acute Rockwood type IV-V AC joint separation.
Methods
This single-center retrospective analysis included 49 male recreational football players who sustained acute, isolated, unilateral Rockwood type IV or V acromioclavicular (AC) joint separation during football participation between January 2015 and December 2023. All patients underwent surgery within 7 days of injury using the same MINAR construct and implant platform, and all procedures were performed by the same experienced surgical team. Postoperative rehabilitation was supervised by the institutional physiotherapy department, generally three times weekly, with progression individualized according to clinical recovery. The primary outcome was the change in Constant score from preoperative assessment to 24 months. Secondary outcomes included Taft, American Shoulder and Elbow Surgeons (ASES), and visual analog scale (VAS) pain scores; minimal clinically important difference (MCID) achievement; coracoclavicular (CC) distance; return to unrestricted match play; return to preinjury football level; and exploratory comparisons according to vertical reduction status. Coracoclavicular distance was measured independently by three blinded observers, and the mean of the three measurements was used for the radiographic analyses. Radiographic loss of vertical reduction was defined a priori as a 24-month injured-to-contralateral CCD ratio greater than 1.50. Because only five patients met this criterion, comparisons according to vertical reduction status were considered exploratory and descriptive.