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Vossen RJM, Verstift D, Van Etten-Jamaludin FS, Hamans BJ, van den Bekerom MPJ, Verweij LPE. Choice of Acromioclavicular Dislocation Treatment Should Not Be Influenced by Risk of Development of Acromioclavicular Osteoarthritis: A Systematic Review With Meta-Analysis. JBJS Rev 2024; 12:01874474-202409000-00002. [PMID: 39226400 DOI: 10.2106/jbjs.rvw.24.00085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2024]
Abstract
BACKGROUND It is currently unknown to what degree surgical or nonoperative treatment of acromioclavicular (AC) dislocation influences the development of osteoarthritis (OA). The aim of this study was to evaluate AC OA after surgical and nonoperative treatment for AC dislocations, compare OA prevalence between treatment options, and compare OA prevalence between the injured and contralateral shoulder. METHODS Articles reporting on the prevalence of OA after surgical or nonoperative treatment of an AC dislocation with a minimal 2-year follow-up were included. AC OA presence was extracted for the injured and contralateral shoulder. Treatment categories were defined based on anatomical variation in the reattachment of ligaments: AC fixation, coracoclavicular (CC) fixation, AC and CC fixation, Bosworth screw synthetic graft, tendon graft, and conservative. Study quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria. RESULTS Ninety-four articles were included for qualitative analysis, and 7 articles were included for meta-analysis (n = 3,812; follow-up = 2.0-24.2 years; mean age 37.6 ± 10.4 years). A total of 3,483 patients underwent surgical treatment, and 329 patients underwent conservative treatment. OA prevalence ranged from 6.7%-29.3% between 7 pooled treatment categories. Most included studies had a follow-up <10 years (94%) and OA prevalence increased with time, regardless of treatment option. There was no difference in OA prevalence between the injured and contralateral shoulder (p = 0.120). MINORS scores were varied, ranging from poor to very good. CONCLUSION The pooled AC OA prevalence of the 7 treatment categories ranged from 6.7% for the CC fixation surgical group to 29.3% for the conservative treatment group. However, the included studies were predominantly of low quality and had varying follow-up periods, with most having relatively short follow-up durations. No difference in AC OA prevalence was found between the injured and contralateral shoulder. Based on the available evidence, treatment choice for AC dislocation should not be influenced by the potential development of AC AO. LEVEL OF EVIDENCE Level IV. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Roderick J M Vossen
- Department of Orthopedics, OLVG, Amsterdam, the Netherlands
- Amsterdam Shoulder and Elbow Centre of Expertise (ASECE), Amsterdam, the Netherlands
- Department of Orthopedic Surgery and Sports Medicine, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Daniel Verstift
- Department of Orthopedics, OLVG, Amsterdam, the Netherlands
- Amsterdam Shoulder and Elbow Centre of Expertise (ASECE), Amsterdam, the Netherlands
| | | | - Bryan J Hamans
- Department of Orthopedic Surgery and Sports Medicine, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Michel P J van den Bekerom
- Department of Orthopedics, OLVG, Amsterdam, the Netherlands
- Amsterdam Shoulder and Elbow Centre of Expertise (ASECE), Amsterdam, the Netherlands
- Department of Human Movement Sciences, Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands
| | - Lukas P E Verweij
- Amsterdam Shoulder and Elbow Centre of Expertise (ASECE), Amsterdam, the Netherlands
- Department of Orthopedic Surgery and Sports Medicine, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam, the Netherlands
- Musculoskeletal Health Program, Amsterdam Movement Sciences, Amsterdam, the Netherlands
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Maliwankul K, Kanyakool P, Klabklay P, Parinyakhup W, Boonriong T, Chuaychoosakoon C. Progressive Loss of Acromioclavicular Joint Reduction Correlated with Progressive Clavicular Tunnel Widening after Coracoclavicular Stabilization in Acute High-Grade Acromioclavicular Joint Injury. J Clin Med 2024; 13:4446. [PMID: 39124713 PMCID: PMC11313541 DOI: 10.3390/jcm13154446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Revised: 07/22/2024] [Accepted: 07/24/2024] [Indexed: 08/12/2024] Open
Abstract
Objectives: This study aimed to compare 24-month radiographic follow-ups of clavicular tunnel widenings (CTWs) and coracoclavicular distances (CCDs) and examine correlations between these measurements in patients following combined coracoclavicular stabilization and acromioclavicular capsule repair in treatment of acute high-grade acromioclavicular joint injury. Methods: This retrospective study reviewed the records of patients with acute Rockwood type V acromioclavicular joint injury who underwent surgery within 3 weeks after their injury. All patients had follow-ups at 3 and 6 months and 1 and 2 years. The CTWs were measured on anteroposterior radiographs between the medial and lateral borders at the superior, middle and inferior levels of the tunnels. On anteroposterior radiographs of both clavicles, the CCDs were measured at the shortest distance between the upper border of the coracoid process and the inferior border of the clavicle and reported as the CCD ratio, which was defined as the ratio of the affected and unaffected clavicles. At the final follow-ups, clinical outcomes were assessed using American Shoulder and Elbow Surgeons (ASES) scores. Results: This study included seventeen men and six women with a mean age of 47.26 ± 10.68 years. At the final follow-ups, the mean ASES score of all patients was 95.28 ± 3.62. We found a significant correlation between the increase in the CTWs and the increase in the CCD ratios (Spearman's rho correlation coefficient range 0.578-0.647, all p-values < 0.001). Conclusions: We found long-term postoperative widening of the clavicular tunnels, which correlated positively with a gradual postoperative decline in the acromioclavicular joint alignment reductions.
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Affiliation(s)
| | | | | | | | | | - Chaiwat Chuaychoosakoon
- Department of Orthopedics, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand
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Senel A, Eren M, Batur OC, Kaya O, Sert S, Key S. The Effect of Clavicular Tunnel Position on Reduction Loss in Patients with Acute Acromioclavicular Joint Dislocations Operated with a Single-Bundle Suspensory Loop Device. Orthop Surg 2024; 16:1622-1630. [PMID: 38766809 PMCID: PMC11216842 DOI: 10.1111/os.14095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 04/23/2024] [Accepted: 04/26/2024] [Indexed: 05/22/2024] Open
Abstract
OBJECTIVE The treatment of acromioclavicular joint (ACJ) dislocations offers numerous options, and ongoing debates persist regarding their comparative effectiveness. Among these options, the suspensory loop device (SLD) is one of the most favored treatment modalities. Despite the observed high reduction loss rate associated with SLD, the treatment yields favorable clinical outcomes. This study aimed to investigate the clinical outcomes of patients with acute type 3 and 5 ACJ dislocations who underwent open and arthroscopic procedures using a single-bundle SLD, and to evaluate the effect of clavicular tunnel position on reduction loss. METHODS Thirty-seven eligible patients diagnosed with acute type 3 and type 5 ACJ dislocation who underwent open and arthroscopic surgery with a single-bundle SLD between January 2015 and March 2022 were evaluated retrospectively. Demographic data and radiological measurements including coracoclavicular (CC) interval, clavicle length (CL), and implant distance (ID) were recorded. The ID/CL ratio was calculated and a value between 0.17 and 0.24 was considered as "acceptable implant position". Reduction loss and other complications were noted. Patients were divided into two groups: open (Group 1) and arthroscopic (Group 2). Constant Murray Score (CMS) and Visual Analog Scale (VAS) were used for clinical and functional outcomes. Non-parametric tests were used for statistical analysis of variables. RESULTS The study included six females (16.2%) and 31 males (83.8%) with a mean age of 40.2 ± 14.7 years (range: 20-75). The mean follow-up period was 22.3 ± 16.7 months (range: 6-72). The average time from trauma to surgery was 6.3 ± 5.3 days (range: 1-18). At the last follow-up, the CMS was 89.3 ± 8.8 and the VAS score was 2.1 ± 0.9. The mean ID/CL ratio was 0.19 ± 0.1 and 19 patients (51.4%) were between 0.17 and 0.24. Reduction loss was observed in nine patients (24.3%). There were no significant differences between Group 1 and Group 2 regarding operation time (p = 0.998), ID/CL ratio (p = 0.442), reduction loss (p = 0.458), CMS (p = 0.325), and VAS score (p = 0.699). Of the 28 patients without reduction loss, 16 had an ID/CL ratio between 0.17 and 0.24 (p = 0.43). Furthermore, within the 0.17-0.24 interval, CMS was higher with an average of 91.8 ± 5.1 compared to the other intervals (p = 0.559). CONCLUSION The clinical and functional outcomes of acute type 3 and type 5 ACJ dislocation operated open and arthroscopically with single-bundle SLD are similar and satisfactory. A clavicular tunnel position in the range of 0.17-0.24 (ID/CL ratio) is recommended to maintain postoperative reduction.
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Affiliation(s)
- Ahmet Senel
- Orthopedics and Traumatology DepartmentIstanbul Training and Research HospitalIstanbulTurkey
| | - Murat Eren
- Orthopedics and Traumatology DepartmentIstanbul Training and Research HospitalIstanbulTurkey
| | - Omer Cihan Batur
- Orthopedics and Traumatology DepartmentElazig Fethi Sekin City HospitalElazigTurkey
| | - Oguz Kaya
- Orthopedics and Traumatology DepartmentElazig Fethi Sekin City HospitalElazigTurkey
| | - Selman Sert
- Orthopedics and Traumatology DepartmentIstanbul Training and Research HospitalIstanbulTurkey
| | - Sefa Key
- Department of Orthopedics and TraumatologyFirat University Faculty of MedicineElazigTurkey
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Van Eecke E, Struelens B, Muermans S. Long-term clinical and radiographic outcomes of arthroscopic acromioclavicular stabilization for acute acromioclavicular joint dislocation. Clin Shoulder Elb 2024; 27:219-228. [PMID: 38738320 PMCID: PMC11181058 DOI: 10.5397/cise.2023.01060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/16/2024] [Accepted: 01/20/2024] [Indexed: 05/14/2024] Open
Abstract
BACKGROUND Standard open acromioclavicular (AC) stabilization is associated with increased postoperative complications including deltoid injury, infection, tunnel complications, loss of reduction, and wound/cosmetic concerns. Arthroscopy may offer superior visualization and advantages that limit these risks. The aim of this prospective non-randomized study is to evaluate advantages and long-term reliability of arthroscopic AC stabilization. METHODS Thirty-two patients with acute grade III, IV and V AC dislocations underwent arthroscopic AC reconstruction with long-term assessment by clinical AC examination, Simple Shoulder Test, American Shoulder and Elbow Surgeons scores, visual analog scale, Specific AC Score and Quick Disabilities of the Arm, Shoulder and Hand scores. Radiographs verified conservation of initial reduction and presence of coracoclavicular (CC) ossifications. Complications, revision rate, and satisfaction were assessed and compared to the literature. RESULTS Mean follow-up time was 67.6 months. All clinical outcome scores improved and differences were statistically significant (P<0.001). Initial postoperative radiographs consistently showed complete reduction. Two patients experienced relapse to grade II AC dislocation without clinical implications. In total, 71.8% showed CC ossifications without functional impairment, and in 31.3% concomitant injuries were observed. Reintervention rate was 9.4%, and 96.9% of patients were satisfied with procedure outcomes. CONCLUSIONS Arthroscopic stabilization for acute AC joint dislocations offers satisfactory clinical and radiographic outcomes, and our results show that the arthroscopic technique is reliable in the long run. We report better reduction in maintenance, fewer complications, and similar reoperation rates compared to other techniques. Level of evidence: III.
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Affiliation(s)
- Eduard Van Eecke
- Department of Orthopedic Surgery, AZ Delta Roeselare, Roeselare, Belgium
| | | | - Stijn Muermans
- Department of Orthopedic Surgery, AZ Delta Roeselare, Roeselare, Belgium
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Navarro R, Kody M, Chapek M, Combs K. Acromioclavicular joint dislocation: a novel surgical technique for acromioclavicular joint reduction with coracoclavicular ligament reconstruction and anatomic conoid ligament reconstruction. JSES REVIEWS, REPORTS, AND TECHNIQUES 2024; 4:213-221. [PMID: 38706662 PMCID: PMC11065762 DOI: 10.1016/j.xrrt.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Affiliation(s)
- Ronald Navarro
- Department of Orthopedic Surgery, Southern California Permanente Medical Group, Harbor City, CA, USA
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA
| | - Michael Kody
- Department of Orthopaedic Surgery, Harbor-University of California, Los Angeles Medical Center, Torrance, CA, USA
| | - Michael Chapek
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA
| | - Kristen Combs
- Department of Orthopaedic Surgery, Harbor-University of California, Los Angeles Medical Center, Torrance, CA, USA
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Xiao M, Abrams GD. Editorial Commentary: Acromioclavicular Joint Reconstruction With Double-Bundle Constructs Provides Improved Maintenance of Reduction but Comparable Clinical Outcomes Versus Single-Bundle Constructs. Arthroscopy 2024:S0749-8063(24)00299-8. [PMID: 38697326 DOI: 10.1016/j.arthro.2024.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Accepted: 04/16/2024] [Indexed: 05/04/2024]
Abstract
Treatment of acute acromioclavicular (AC) joint separations is dependent on a variety of factors, including severity, acuity, patient demographics, activity level, and surgeon preferences. For more severe or unstable separations (Rockwood types IIIB, IV, V, and VI), surgical intervention is typically recommended. Over 160 surgical techniques have been described, but none have emerged as a gold standard. Arthroscopic-assisted or all-arthroscopic fixation of the coracoclavicular ligaments with suture buttons has become increasingly popular due to lower complication rates compared with more rigid fixation. Configurations include single-bundle (SB) constructs and double-bundle (DB) configurations that more anatomically reconstruct the conoid and trapezoid ligaments but with longer operative times. Clinical studies with short-term follow-up have demonstrated improved maintenance of fixation for DB compared with SB constructs but no significant differences in clinical outcomes. In our experience, SB suture button-only constructs lead to unacceptable failures due to loss of reduction. We recommend either a single suture button construct augmented with allograft or DB suture button constructs for the treatment of acute AC joint separations.
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Vetter P, Eckl L, Bellmann F, Allemann F, Scheibel M. [Minimally Invasive Techniques for the Treatment of Acute and Chronic Acromioclavicular Joint Instabilities]. ZEITSCHRIFT FUR ORTHOPADIE UND UNFALLCHIRURGIE 2023; 161:219-238. [PMID: 37015240 DOI: 10.1055/a-1781-6153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
Acromioclavicular joint instabilities are one of the most common injuries of the shoulder girdle. Diagnostic measures include the vertical and horizontal components of instability. The main goals of treatment include pain reduction, joint stabilization, and return to physical activity. For operative treatment, there are numerous techniques available. Recently, minimally-invasive techniques were developed and showed equal results as with open approach. These procedures facilitate simultaneous treatment of concomitant shoulder lesions and reduce soft tissue trauma as well as the risk of infection. This article presents an overview of such minimally-invasive techniques for both acute and chronic instabilities. Both techniques address the aspect of horizontal instability, which was found to compromise clinical results. For an acute injury, we describe the use of a low-profile button system combined with an additional acromioclavicular cerclage. In the chronic setting with a bidirectional (vertical and horizontal) instability, a free tendon graft combined with a single TightRope augmentation is recommended.
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Park I, Lee S, Shin SJ. Arthroscopic-Assisted Double-Bundle Coracoclavicular Ligament Reconstruction Using Cortical Fixation Buttons With Suture Tape Provides Superior Vertical Stability Than the Single-Bundle Reconstruction for Acute Acromioclavicular Joint Dislocation. Arthroscopy 2023; 39:213-221. [PMID: 36210032 DOI: 10.1016/j.arthro.2022.09.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 08/18/2022] [Accepted: 09/26/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE This study aimed to compare clinical and radiologic outcomes between single- and double-bundle arthroscopic-assisted coracoclavicular (CC) ligament reconstruction using cortical fixation buttons with suture tapes for acute acromioclavicular (AC) joint dislocation. METHODS Patients who underwent arthroscopic-assisted CC ligament reconstruction using cortical fixation buttons with suture tapes for acute AC joint dislocation from July 2014 to March 2019 were identified. This study included patients treated for acute AC joint dislocation within 2 weeks after an injury, with a Rockwood classification of III or V and at least 2 years of follow-up. Patients were divided into 2 groups based on the reconstruction technique: group I (single-bundle technique) and group II (double-bundle technique). The clinical outcomes were compared using the American Shoulder Elbow Surgeons (ASES) score, Constant score, and visual analog scale for pain score between the 2 groups. On the plain radiograph, the CC interval ratio (CCIR) was measured to evaluate maintenance of CC interval fixation. Postoperative complications, including reduction failure, were also documented. RESULTS Fifty-eight patients (26 in group I, 32 in group II) were enrolled. There were no significant differences in CCIR between the 2 groups preoperatively and 3 months postoperatively. However, the CCIR of group I was significantly greater than that of group II 6 months postoperatively (group I: 160.5% ± 48.5%, group II: 125.4% ± 38.9% at 6 months postoperatively, P = .01; group I: 164.0% ± 57.3%, group II: 123.2% ± 35.9% at the last visit, P = .01). Despite radiologic differences, the clinical outcomes demonstrated no significant differences between 2 the groups (ASES score: 93.5 ± 5.2 in group I, 94.4 ± 4.5 in group II, P = .54; Constant score: 92.9 ± 5.3 in group I, 94.8 ± 4.3 in group II, P = .16). Reduction failure occurred in 4 patients (15.3%) in group I and in 1 patient (3.2%) in group II (P = .16). CONCLUSIONS Arthroscopic-assisted double-bundle CC ligament reconstruction using cortical fixation buttons with suture tapes provided superior vertical stability than the single-bundle technique. LEVEL OF EVIDENCE Level III, retrospective comparative study.
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Affiliation(s)
- In Park
- Department of Orthopedic Surgery, College of Medicine, Ewha Womans University Seoul Hospital, Seoul, Republic of Korea
| | - Sanghyeon Lee
- Department of Orthopedic Surgery, Seoul Medical Center, Seoul, Republic of Korea
| | - Sang-Jin Shin
- Department of Orthopedic Surgery, College of Medicine, Ewha Womans University Seoul Hospital, Seoul, Republic of Korea.
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Allahabadi S, Chahla J. Editorial Commentary: Coracoclavicular Joint Reconstruction for Acromioclavicular Dislocation: Double-Bundle Techniques Are Anatomically and Biomechanically Favored. Arthroscopy 2023; 39:222-224. [PMID: 36603992 DOI: 10.1016/j.arthro.2022.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 10/20/2022] [Indexed: 01/04/2023]
Abstract
For coracoclavicular (CC) joint reconstruction in the setting of acute acromioclavicular (AC) joint Rockwood type III or V dislocations, flexible fixation shows better clinical outcomes and complication rates than rigid fixation. Single-bundle CC reconstruction reconstructs the conoid ligament but poorly controls anteroposterior stability and is nonanatomic in nature. Thus, we favor double-bundle CC reconstruction incorporating a trapezoid bundle, replicating the broad insertion of the CC ligaments. Biomechanical data confirm improved stability with double-bundle, flexible fixation reconstruction, especially with the lateral clavicular tunnel in a more posterolateral location. An early clinical outcome study supports the double-bundle approach; meticulous surgical technique is required to avoid double-trouble complication rates.
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Klabklay P, Kwanyuang A, Tangjatsakow P, Kala S, Suklim P, Naknual N, Chuaychoosakoon C. Comparing the Anatomical Landmarks Versus the Coracoid-Based Landmarks Techniques for Coracoclavicular Stabilization After High-Grade Acromioclavicular Injury: A Biomechanical Study. Orthop J Sports Med 2022; 10:23259671221132541. [PMID: 36419477 PMCID: PMC9676306 DOI: 10.1177/23259671221132541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 08/10/2022] [Indexed: 08/30/2023] Open
Abstract
BACKGROUND In acute high-grade acromioclavicular (AC) joint injuries, the aim of treatment is robust reduction and stabilization of the joint. The anatomical landmarks method is most commonly used for stabilization, but loss of reduction often occurs because of the suture tunnels. PURPOSE/HYPOTHESIS The purpose was to evaluate and compare the stability of coracoclavicular (CC) stabilization using the anatomical landmarks and coracoid-based landmarks techniques in treating a high-grade AC joint injury. It was hypothesized that stabilization using coracoid-based landmarks would provide better stability. STUDY DESIGN Controlled laboratory study. METHODS Twenty fresh-frozen cadaveric shoulders (8 male and 2 female pairs) were randomized into 2 operative technique groups: 10 shoulders in the anatomical landmarks group and 10 shoulders in the coracoid-based landmarks group. The CC ligaments and AC capsule were cut at the midlevel, and CC stabilization and AC capsule repair were performed. For the anatomical landmarks technique, two 2.5-mm clavicular tunnels were created at 25 and 45 mm from the AC joint, while for the coracoid-based landmarks technique, two 2.5-mm clavicular tunnels were drilled using the medial and lateral borders of the coracoid base to choose the tunnel sites. Before injury creation and after stabilization, each shoulder underwent a loading force of 70 N in the superior and anteroposterior directions, and the displacement distance and stiffness were compared between the 2 techniques using the paired t test. RESULTS The mean difference in displacement before and after stabilization was higher in the anatomical landmarks technique than the coracoid-based landmarks technique (1.82 ± 3.52 vs -0.18 ± 4.78 mm in the superior direction and 7.47 ± 9.35 vs 1.76 ± 3.91 mm in the anteroposterior direction), but none of the differences in displacement or stiffness were statistically significant between the groups. CONCLUSION No significant biomechanical differences in displacement or stiffness were seen between the anatomical landmarks technique and the coracoid-based landmarks technique. CLINICAL RELEVANCE Either stabilization technique can be utilized for repair of the CC ligaments in an acute AC injury setting.
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Affiliation(s)
- Prapakorn Klabklay
- Department of Orthopedics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Atichart Kwanyuang
- Department of Biomedical Sciences and Biomedical Engineering, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Preyanun Tangjatsakow
- Department of Orthopedics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Sataporn Kala
- Department of Biomedical Sciences and Biomedical Engineering, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Phachara Suklim
- Department of Biomedical Sciences and Biomedical Engineering, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Nutnicha Naknual
- Department of Biomedical Sciences and Biomedical Engineering, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
| | - Chaiwat Chuaychoosakoon
- Department of Orthopedics, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand
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Fandridis EΜ, Zampeli F, Dimakopoulos P. Arthroscopically Assisted Double-Loop Suture Repair for Acute Acromioclavicular Joint Disruption. Arthrosc Tech 2022; 11:e937-e946. [PMID: 35646578 PMCID: PMC9134684 DOI: 10.1016/j.eats.2022.01.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 01/14/2022] [Indexed: 02/03/2023] Open
Abstract
The surgical management of acute high-grade acromioclavicular (AC) joint (ACJ) injuries has evolved during the last decades. Numerous surgical techniques exist and recently arthroscopically assisted or all endoscopic techniques have gained popularity due to certain advantages. The goals of the new anatomic coracoclavicular ligament reconstruction techniques are to achieve anatomic reduction of the ACJ to allow and facilitate primary healing of AC and coracoclavicular (CC) ligaments, and also to minimize the risk of associated complications. We regularly use the open repair with double-loop sutures for the acute ACJ disruption, as described by Dimakopoulos et al. at 2006. In this surgical technique article, we present the arthroscopically assisted technique for the double-loop suture repair.
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Affiliation(s)
- Emmanouil Μ. Fandridis
- Hand-Upper Limb-Microsurgery Department, General Hospital KAT(E.M.F., F.Z.); and Athens, Greece(P.D.)
| | - Frantzeska Zampeli
- Hand-Upper Limb-Microsurgery Department, General Hospital KAT(E.M.F., F.Z.); and Athens, Greece(P.D.).,Address correspondence to Frantzeska Zampeli, M.D., Ph.D., KAT General Hospital, Nikis 2, Kifisia, Postal code 145 61, Greece.
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