{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T12:58:38Z","timestamp":1774529918003,"version":"3.50.1"},"reference-count":39,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2018,7,6]],"date-time":"2018-07-06T00:00:00Z","timestamp":1530835200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2018,7,6]],"date-time":"2018-07-06T00:00:00Z","timestamp":1530835200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Traumatic high\u2010grade acromioclavicular joint (ACJ) separations can be surgically stabilized by numerous anatomic and non\u2010anatomic procedures. The return to sport (Maffe et al. in Am J Sports Med 23:93\u201398, 1995] and remaining sport\u2010associated impairments after acute ACJ stabilization has not yet been investigated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>73 consecutive athletes with acute high\u2010grade ACJ separation were prospectively assigned into two groups (64.4% randomized, 35.6% intention\u2010to\u2010treat): open clavicular hook plate (cHP) implantation (GI) or arthroscopically assisted double double\u2010suture\u2010button (dDSB) implantation (GII). Patients were analyzed using shoulder sport\u2010specific measurement tools for sport ability (ASOSS), sport activity (SSAS), and numerical analog scales: NAS<jats:sub>pain during sport<\/jats:sub>, NAS<jats:sub>shoulder function in sport<\/jats:sub>, and NAS<jats:sub>re\u2010achievement of sport level<\/jats:sub>. Four points of examination were established: preoperative evaluation (FU0) and first postoperative follow\u2010up (FU1) at 6\u00a0months; FU2 at 12\u00a0months; and FU3 at 24\u00a0months after surgery. The control group (GIII) consisted of 140 healthy athletes without anamnesis of prior macro\u2010injury or surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After surgical stabilization, 29 of 35 athletes in GI (82.9%; 38.6\u2009\u00b1\u20099.9 years) and 32 of 38\u00a0in GII (82.9%; 38.6\u2009\u00b1\u20099.9 years) were followed up for 24\u00a0months (FU3) (loss 17.8%). All operated athletes showed significantly increased scores compared to FU0 (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Compared to GI, GII showed significantly superior outcome data for sporting ability as well as for NAS<jats:sub>re\u2010achievement of sport level<\/jats:sub> (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). While GII re\u2010achieved GIII\u2010comparable SSAS and ASOSS levels, GI remained at a significantly inferior level. Athletes after ACJ injury of Rockwood grade IV\/V and overhead athletes benefited significantly from the dDSB procedure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The dDSB procedure enabled significantly superior sport\u2010specific outcomes compared to the cHP procedure. Athletes after dDSB surgeries re\u2010achieved the sporting ability and the sport activity levels of healthy athletes, whereas athletes after cHP implantation remained at significantly inferior levels. The more extensive dDSB procedure and the more restrictive rehabilitation are recommended for treatment of acute high\u2010grade ACJ separations of functionally high\u2010demanding athletes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>I.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-018-5044-x","type":"journal-article","created":{"date-parts":[[2018,7,6]],"date-time":"2018-07-06T03:13:20Z","timestamp":1530846800000},"page":"3832-3847","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Return to sport after acute acromioclavicular stabilization: a randomized control of double\u2010suture\u2010button system versus clavicular hook plate compared to uninjured shoulder sport athletes"],"prefix":"10.1002","volume":"26","author":[{"given":"D.","family":"M\u00fcller","sequence":"first","affiliation":[{"name":"<!--<label>2<\/label>--> Department of Trauma and Orthopedic Surgery Berufsgenossenschaftliche Unfallklinik Frankfurt am Main Frankfurt Germany"},{"name":"<!--<label>4<\/label>--> Department of Trauma, Hand and Reconstructive Surgery University Hospital Frankfurt am Main Frankfurt Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y.","family":"Reinig","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Department of Trauma and Orthopedic Surgery Berufsgenossenschaftliche Unfallklinik Frankfurt am Main Frankfurt Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Hoffmann","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Department of Trauma and Orthopedic Surgery Berufsgenossenschaftliche Unfallklinik Frankfurt am Main Frankfurt Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Blank","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Department of Trauma and Orthopedic Surgery Berufsgenossenschaftliche Unfallklinik Frankfurt am Main Frankfurt Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Welsch","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Sporttraumatology\u2010Knee\u2010 and Shoulder\u2010Surgery Berufsgenossenschaftliche Unfallklinik Frankfurt am Main Friedberger Landstra\u00dfe 430 60389 Frankfurt Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"U.","family":"Schweigkofler","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Department of Trauma and Orthopedic Surgery Berufsgenossenschaftliche Unfallklinik Frankfurt am Main Frankfurt Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9970-3528","authenticated-orcid":false,"given":"T.","family":"Stein","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Sporttraumatology\u2010Knee\u2010 and Shoulder\u2010Surgery Berufsgenossenschaftliche Unfallklinik Frankfurt am Main Friedberger Landstra\u00dfe 430 60389 Frankfurt Germany"},{"name":"<!--<label>3<\/label>--> Department of Sports Science University of Bielefeld Bielefeld Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,7,6]]},"reference":[{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/JSA.0b013e3181595c51"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.3233\/BMR\u20102011\u20100291"},{"key":"e_1_2_9_4_2","doi-asserted-by":"publisher","DOI":"10.4137\/CMAMD.S7880"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2012.11.023"},{"key":"e_1_2_9_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546510382887"},{"key":"e_1_2_9_7_2","doi-asserted-by":"publisher","DOI":"10.1080\/09593980701247337"},{"key":"e_1_2_9_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2015.10.060"},{"key":"e_1_2_9_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/1754\u20109485.12276"},{"key":"e_1_2_9_10_2","doi-asserted-by":"publisher","DOI":"10.12659\/PJR.889615"},{"key":"e_1_2_9_11_2","first-page":"963","article-title":"Shoulder pain in the overhand or throwing athlete. 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Stein has received payment for instructional courses. Other authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The institutional ethics committee approved all data-collection and randomising procedures (clinical trial registry number: FF 42\/2011).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"All subjects provided informed consent.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}