Risk factors related to the loss of reduction after acromioclavicular joint dislocation treated with the EndoButton device

BACKGROUND: Anatomic ligament reconstruction using the EndobutBon device has been proven an effective technique for the management of acute acromioclavicular (AC) joint dislocation. The aim of this study was to analyze the risk factors causing loss of reduction after AC joint dislocation treated with the EndoButton device for open procedures. METHODS: A total of 107 patients who met the inclusion and excluded criteria finally were enrolled. We retrospectively analyzed the clinical tests, imaging data, and postoperative rehabilitation of patients in a stable reduction group and a loss of reduction group. RESULTS: Among all patients included in the study, the incidence of reduction failure was 14%. Univariate analysis identified that the time between injury to surgery, double or triple EndoButton, coracoid EndoButton position, weight-bearing time of the upper limb, and osteolysis had statistically significant associations with loss of reduction for the AC joint (P=0.022, 0.002, 0.000, 0.000, and 0.000 respectively). By using multivariate logistic regression analysis, we found that coracoid EndoButton position (P=0.002), weight-bearing time of the upper limb (P=0.011), and osteolysis (P=0.036) were the significant independent risk factors related to the loss of reduction after AC joint dislocation treated with the EndoButton device used with open procedures. CONCLUSIONS: In order to reduce the incidence of reduction failure and improve the prognosis of patients, more accurate placement of EndoButton plates in surgery and guidance for patients in completing planned rehabilitation training are needed.