Background:Numerous techniques have been used to treat acromioclavicular (AC) joint dislocation, with anatomic reconstruction of the coracoclavicular (CC) ligaments becoming a popular method of fixation. Anatomic CC ligament reconstruction is commonly performed with cortical fixation buttons (CFBs) or tendon grafts (TGs).Purpose:To report and compare short-term complications associated with AC joint stabilization procedures using CFBs or TGs.Study Design:Cohort study; Level of evidence, 3.Methods:We conducted a retrospective review of the operative treatment of AC joint injuries between April 2007 and January 2013 at 2 institutions. Thirty-eight patients who had undergone a procedure for AC joint instability were evaluated. In these 38 patients with a mean age of 36.2 years, 18 shoulders underwent fixation using the CFB technique and 20 shoulders underwent reconstruction using the TG technique.Results:The overall complication rate was 42.1% (16/38). There were 11 complications in the 18 patients in the CFB group (61.1%), including 7 construct failures resulting in a loss of reduction. The most common mode of failure was suture breakage (n = 3), followed by button migration (n = 2) and coracoid fracture (n = 2). There were 5 complications in the TG group (25%), including 3 cases of asymptomatic subluxation, 1 symptomatic suture granuloma, and 1 superficial infection. There were no instances of construct failure seen in TG fixations. CFB fixation was found to have a statistically significant increase in complications (P = .0243) and construct failure (P = .002) compared with TG fixation.Conclusion:CFB fixation was associated with a higher rate of failure and higher rate of early complications when compared with TG fixation.

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In this note, we describe an arthroscopic repair of a degenerative tear of the triceps using a suture weave and an anatomic footprint anchor. We are able to assess, debride, and anatomically repair the distal triceps to its insertion. Compared with open procedures, this arthroscopic repair offers lower morbidity, faster recovery, and improved cosmesis. Our goal was to improve the function and strength of the elbow through this arthroscopic surgical fixation.

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ImportanceTechniques for arthroscopic rotator cuff repair are rapidly evolving. Single-row (SR) and double-row (DR) repair techniques have been well described, but recent studies have suggested the biomechanical superiority of transosseous-equivalent (TOE) DR repairs and triple-row (TR) repairs. However, there is conflicting literature regarding the clinical superiority of one technique over the other.ObjectiveTo systematically review the best available evidence for arthroscopic repair of rotator cuff tears using SR, DR and TR techniques, and to identify predictors of patient functional outcomes and retear rates in each group.Evidence reviewPubMed, Embase, Google Scholar and the Cochrane Database of Systematic Reviews were searched to identify all clinical papers describing arthroscopic repair of rotator cuffs using SR, DR or TR techniques.FindingsThere were 10 papers that met our study criteria; they involved 580 patients. There was no significant difference in clinical outcomes between SR and DR repairs (p=0.57). Studies involving TR repairs were too underpowered to detect any difference in clinical outcomes between SR and DR repairs. The imaging confirmed retear rate of SR repairs was 30.3% (71/234), whereas DR repairs demonstrated a retear rate of 19.3% (41/212). The retear rate of TR repairs was 23.5% (8/34), but the low number of reported TR repairs did not allow us to make any conclusions regarding its superiority or inferiority compared with SR or DR. DR repairs demonstrated a statically significant decrease in retear rates compared with SR repairs (p=0.001). A subgroup analysis of retear rates in SR repairs versus TOE DR repairs demonstrated a trend towards improved structural integrity of the TOE DR repairs, but this was not statistically significant (p=0.07).Conclusions and relevanceThere is no clear difference in clinical outcomes between SR, DR and TR techniques, but DR techniques demonstrate improved structural integrity at short-term follow-up.Level of evidenceIV.

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