Multicenter evaluation of radiological and patient-reported outcomes following surgical treatment of acromioclavicular joint dislocations

PURPOSE: Acromioclavicular (AC) joint dislocations are common injuries in young, active individuals. Surgical reconstruction aims to restore stability, yet loss of reduction is frequently reported. It remains unclear whether radiographic alignment correlates with patient satisfaction and functional outcomes. METHODS: A multicenter retrospective study was conducted, including adult patients with Rockwood type III-VI AC joint injuries, treated surgically between 2019 and 2024. Patients were divided into two groups based on postoperative X‑rays (stable and dislocated), conducted 6 months following surgical treatment. Clinical outcome was assessed using patient-reported outcome measures, including the American Shoulder and Elbow Surgeons (ASES score), the simple shoulder test (SST), single assessment numeric evaluation (SANE) and visual analogue scale (VAS). Radiographic evaluation and clinical outcome at 6 months postoperative were used for analyses in this study. RESULTS: A total of 46 patients (95.7% male, mean age 34.3 years) were included in the present study. No significant correlations were observed between joint position or loosening ratios and patient-reported outcome scores. Overall functional outcomes were excellent in both groups with mean scores of ASES 96.5 ± 8.0, SST 99.2 ± 3.0 and SANE 97.6 ± 9.1, independent of radiographic alignment. Baseline characteristics showed no significant differences between groups. CONCLUSION: In this retrospective cohort, radiographic loss of reduction and postoperative alignment did not correlate with patient satisfaction or functional outcomes at the 6‑month follow-up after AC joint reconstruction. These findings suggest that moderate postoperative displacement can be clinically acceptable in asymptomatic patients when pain relief and functional stability are achieved; however, given the retrospective design, limited sample size and relatively short follow-up period, these observations should be considered hypothesis-generating and require confirmation in larger studies with longer-term follow-up.