Anatomical Evaluation of the Proximity of Neurovascular Structures During Arthroscopically Assisted Acromioclavicular Joint Reconstruction: A Cadaveric Pilot Study

Banaszek, Daniel; Pickell, Michael; Wilson, Evan W; Ducsharm, Melissa; Hesse, Daniel; Easteal, Ron; Bardana, Davide D.

doi:10.1016/j.arthro.2016.05.041

Cited by 13 publications

(14 citation statements)

References 30 publications

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“…The main principle of surgical therapy is accurate reduction of the AC joint in both coronal and sagittal planes. 24 This is achieved either by primary repair or by reconstruction of injured ligaments and maintaining stability to protect this repair or reconstruction. 25 The traditional Weaver-Dunn CA ligament transfer procedure has largely fallen into disfavour today.…”

Section: Managementmentioning

confidence: 99%

“…The suprascapular nerve and the suprascapular artery are the structures with the closest proximity to any implanted material. 24 Besides, arthroscopy makes it possible to get a straight vision of the inferior aspect of the base of the coracoid – a particularly important anatomical area, especially when placing CC fixation systems.…”

Section: Arthroscopic Techniquementioning

confidence: 99%

“…In a cadaveric pilot study performed by Banaszek et al, arthroscopically-assisted techniques are all considered safe and avoid surrounding neurovascular structures, 24 unlike open surgical interventions. However, the proximity of some important neurovascular structures, particularly the suprascapular nerve and the suprascapular artery, must always be remembered.…”

Section: Arthroscopic Techniquementioning

confidence: 99%

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Acromioclavicular joint injuries: diagnosis, classification and ligamentoplasty procedures

2018

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Acromioclavicular (AC) joint injury is a frequent diagnosis after an acute shoulder trauma – often found among athletes and people involved in contact sports.This injury occurs ﬁve times more frequently in men than in women, with the highest incidence in the 20- to 30-year-old age group. Patients usually complain of pain and tenderness over the shoulder, particularly over the AC joint.Depending on the degree of injury, the clavicle may become prominent on the injured site.The original classification was described by Rockwood and Green according to the injured ligament complex and degree and direction of clavicular displacement.Many surgical procedures have been described; among these are screws, plates, muscle transfer, ligamentoplasty procedures and ligament reconstruction using either autograft or allografts.With the advancement of shoulder arthroscopy, surgeons are much more capable of performing mini-open or arthroscopically-assisted procedures, allowing patients an earlier return to their daily living activities. However, the results of conventional open techniques are still comparable.The introduction of new arthroscopic equipment provides a great variety of surgical procedures, though every new technique has its own advantages and pitfalls. Currently there is no gold standard for the surgical treatment of any type of AC injury, though it should be remembered that whenever an arthroscopic technique is chosen, the surgeon’s expertise is likely to be the most significant factor affecting outcome.Cite this article: EFORT Open Rev 2018;3:426-433. DOI: 10.1302/2058-5241.3.170027

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Section: Managementmentioning

confidence: 99%

Section: Arthroscopic Techniquementioning

confidence: 99%

Section: Arthroscopic Techniquementioning

confidence: 99%

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Acromioclavicular joint injuries: diagnosis, classification and ligamentoplasty procedures

2018

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“…T he article "Anatomical Evaluation of the Proximity of Neurovascular Structures During Arthroscopically Assisted Acromioclavicular Joint Reconstruction: A Cadaveric Pilot Study" by Banaszek et al 1 investigates the clearance to important neurovascular structures when performing a minimally invasive acromioclavicular (AC) joint reconstruction by subsequent anatomic dissection. The subject of surgical intervention for high-grade AC joint injuries has become a topic of great interest, showing a variety of possible procedures without a recommended standard.…”

Section: See Related Article On Page 75mentioning

confidence: 99%

“…7,8 Individual anatomy can differ significantly between patients as shown by the different anatomic descriptions of the suprascapular nerve and its relation to surrounding structures. 9 However, Banaszek et al 1 showed that an arthroscopic-assisted reconstruction with a coracoclavicular suspension device and a looped graft around the coracoid base can be performed safely and reproducibly.…”

Section: See Related Article On Page 75mentioning

confidence: 99%

Editorial Commentary: Arthroscopically Assisted Acromioclavicular Joint Reconstruction—Not Seeing Does Not Mean Do Not Worry

Imhoff¹,

Dyrna²

2017

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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To minimize risks during arthroscopic-assisted reduction and internal fixation of acromioclavicular dislocation, drilling should only be performed with an anatomically reduced clavicle. This re-creates the important distances to the neurovascular structures because a posteriorly displaced clavicle reduces the distance to the suprascapular nerve. In addition, visualization is of high importance for the arthroscopic coracoid preparation, as are mini-open incisions, to create an accurate and well-placed tunnel for drilling. Last, because the highest potential risk of neurovascular injuries occurs with the drilling itself instead of the final construct, all possible assistance and supports guiding the surgeon should be used to avoid any pitfalls. Hence, radiography and arthroscopy are helpful tools to create and check precise tunnel placement. Still, there are risks, and surgeons must be aware of and mitigate against neurovascular complications.

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The Arthroscopy-Assisted Anatomical Reconstruction of Acromioclavicular and Coracoclavicular Ligament in Chronic Acromioclavicular Joint Dislocation

C้hernchujit

Prasetia

2019

Intraarticular Fractures

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Anatomical Evaluation of the Proximity of Neurovascular Structures During Arthroscopically Assisted Acromioclavicular Joint Reconstruction: A Cadaveric Pilot Study

Cited by 13 publications

References 30 publications

Acromioclavicular joint injuries: diagnosis, classification and ligamentoplasty procedures

Acromioclavicular joint injuries: diagnosis, classification and ligamentoplasty procedures

Editorial Commentary: Arthroscopically Assisted Acromioclavicular Joint Reconstruction—Not Seeing Does Not Mean Do Not Worry

The Arthroscopy-Assisted Anatomical Reconstruction of Acromioclavicular and Coracoclavicular Ligament in Chronic Acromioclavicular Joint Dislocation

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