All-Arthroscopic Coracoclavicular Ligament Reconstruction Surgical Technique Using a Semitendinosus Allograft and Tenodesis Screws

Li, Xinning; Padmanabha, Anand; Koh, Justin; Cusano, Antonio

doi:10.1016/j.eats.2016.10.018

Cited by 4 publications

(4 citation statements)

References 4 publications

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“…5,8 Several surgical techniques have been proposed to treat AC joint dislocation. 5,7,8,12,18,19,22 In a recent systematic review, the complication rate after use of a suspensory device was 6.2% lower than that after hook plate/K-wire treatment (26.3%), Weaver-Dunn or modified Weaver-Dunn technique (12.8%), or free graft reconstruction (10.3%). 17 In most studies that used a suspensory system, at least 2 tunnels were drilled in both the coracoid and clavicle.…”

mentioning

confidence: 99%

Clinical Outcome of a Modified Coracoid Tunnel-Free Coracoclavicular Sling Technique With Remnant Preservation for the Treatment of High-Grade Acromioclavicular Joint Separation: A Report of 48 Cases With 2 to 5 Years of Follow-up

et al. 2021

Am J Sports Med

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Background: High-grade acromioclavicular (AC) joint separation injuries (Rockwood type IV or V) are surgically indicated because of complete disruption of the AC and coracoclavicular (CC) ligaments, leading to instability and pain. In surgical techniques that require a suspensory system, coracoid tunnel-related complications are not uncommon. Purpose: To report subjective and objective clinical outcomes and complication rates of a modified coracoid tunnel-free CC sling technique combined with CC ligament remnant preservation for a minimum 2-year follow-up. Study Design: Case series; Level of evidence, 4. Methods: Between January 2014 and January 2017, we prospectively enrolled patients who underwent a modified CC sling technique performed by 1 senior surgeon using the AC TightRope System in a coracoid tunnel-free fashion. The CC distance (CCD) and Rockwood AC joint classification were evaluated on radiographs preoperatively, immediately postoperatively, and at the final follow-up. The visual analog pain score, range of motion, American Shoulder and Elbow Surgeons score, Constant-Murley score, and University of California Los Angeles score were recorded preoperatively and at the final follow-up. Results: In total, 48 of 54 patients (88.9%) were included for the evaluation with a mean ± SD follow-up of 39.3 ± 8.9 months (range, 24.7-64.3 months). The CCD was significantly decreased from 22.7 ± 4.2 to 9.8 ± 2.3 mm ( P < .01) immediately after surgery and to 11.2 ± 1.8 mm ( P < .01) at final follow-up. At the final follow-up, the side-to-side difference of CCD was 3.5 ± 0.6 mm. Compared with the preoperative level, all subjective evaluations were significantly improved at the final follow-up. We observed that 4 of the 48 patients (8.3%) had a loss of reduction at the final follow-up, but no pain or instability was documented. Further, no coracoid-related complication or other complications were recorded. Conclusion: The coracoid tunnel-free CC sling technique using the AC TightRope System combined with CC ligament remnant preservation demonstrated significant improvement regarding both clinical and radiological outcomes, with a reduction loss rate of 8.3%. It is a safe method that could achieve satisfactory result without any coracoid drilling-related complications.

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confidence: 99%

Clinical Outcome of a Modified Coracoid Tunnel-Free Coracoclavicular Sling Technique With Remnant Preservation for the Treatment of High-Grade Acromioclavicular Joint Separation: A Report of 48 Cases With 2 to 5 Years of Follow-up

et al. 2021

Am J Sports Med

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“…13,32,35 The presented data show that sterilized semitendinosus allograft used for anatomical AC-joint stabilization is equivalent to the use of other allografts. 1,2,13,17,29,30 The use of free tendon grafts (ST) together with nonbiological support is widely used for better healing and remodelling times. 7,12,20,22 An artificial band is used to avoid elongation in the first weeks after surgery, but cannot be used alone, because high re-rupture rates are reported with artificial grafts alone.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Currently, there is no consensus regarding the optimal graft choices for AC-joint stabilization. Semitendinosus (ST) allografts 1 , 2 , 11 , 13 , 17 , 20 , 22 , 29 , 30 are mainly used for AC joint reconstruction with other allografts also being used. 2 , 7 , 10 , 11 , 20 , 27 Costic et al 31 concluded that with semitendinosus grafts, the course of the ligaments can be imitated, providing stability to the clavicle similar to that provided by the intact ligaments.…”

Section: Introductionmentioning

confidence: 99%

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Anatomical acromioclavicular joint stabilization with chemically sterilized tendon allografts: A retrospective study

Vogt¹,

Borchert

Ahmed

et al. 2022

Shoulder & Elbow

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Background The purpose of this retrospective study was to analyze whether chemically sterilized tendon allografts perform as well as other non-sterilized allografts and autografts as described in the literature for anatomical acromioclavicular joint stabilization for the treatment of Rockwood III–V. Allografts are still described as a factor for higher re-rupture rates. Methods Retrospective data were collected from 21 acromioclavicular joint stabilizations performed by a single surgeon and performed between 2011 and 2014 using sterilized semitendinosus allografts. The primary endpoints were re-rupture and complication rates. Secondary endpoints were AC-joint stability, pain level, return to work and sport and the range of motion. Results No re-ruptures occurred during the mean follow-up time of 33 months. Zero complications occurred directly after surgery, but three complications later than three weeks after surgery. All cases resolved without further surgery. After surgery, stability significantly improved for all patients. Post-surgery, 19 patients had stable acromioclavicular joints and only two patients showed minor instabilities. Range of motion returned to the range of the healthy shoulders for all patients. Conclusion Chemically sterilized semitendinosus allograft use for anatomic AC-joint stabilization is equivalent to the use of other allografts or autografts and required no hardware removal. No donor age or graft size dependence was observed, due to zero re-ruptures.

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Endoscopic Coracoclavicular Ligament Reconstruction Using Allograft

Efremov

Joslin

2023

Arthroscopy and Endoscopy of the Shoulder

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All-Arthroscopic Coracoclavicular Ligament Reconstruction Surgical Technique Using a Semitendinosus Allograft and Tenodesis Screws

Cited by 4 publications

References 4 publications

Clinical Outcome of a Modified Coracoid Tunnel-Free Coracoclavicular Sling Technique With Remnant Preservation for the Treatment of High-Grade Acromioclavicular Joint Separation: A Report of 48 Cases With 2 to 5 Years of Follow-up

Clinical Outcome of a Modified Coracoid Tunnel-Free Coracoclavicular Sling Technique With Remnant Preservation for the Treatment of High-Grade Acromioclavicular Joint Separation: A Report of 48 Cases With 2 to 5 Years of Follow-up

Anatomical acromioclavicular joint stabilization with chemically sterilized tendon allografts: A retrospective study

Endoscopic Coracoclavicular Ligament Reconstruction Using Allograft

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