Arthroscopic Distal Clavicle and Medial Border of Acromion Resection for Symptomatic Acromioclavicular Joint Osteoarthritis

Apivatgaroon, Adinun; Sanguanjit, Prakasit

doi:10.1016/j.eats.2016.08.033

Cited by 10 publications

(7 citation statements)

References 6 publications

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“…ACJO is a disabling and painful disorder in association with the more common diagnosis of shoulder impingement syndrome[ 1 , 7 , 9 , 10 ]. Inferiorly protruding osteophytes as well as soft tissue hypertrophy of the ACJ accelerates narrowing of the supraspinatus outlet[ 11 - 13 ].…”

Section: Discussionmentioning

confidence: 99%

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Usefulness of the acromioclavicular joint cross-sectional area as a diagnostic image parameter of acromioclavicular osteoarthritis

Joo¹,

Moon²,

Han³

et al. 2022

WJCC

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BACKGROUND Acromioclavicular joint (ACJ) space narrowing has been considered to be an important diagnostic image parameter of ACJ osteoarthritis (ACJO). However, the morphology of the ACJ space is irregular because of osteophyte formation, subchondral irregularity, capsular distention, sclerosis, and erosion. Therefore, we created the ACJ cross-sectional area (ACJCSA) as a new diagnostic image parameter to assess the irregular morphologic changes of the ACJ. AIM To hypothesize that the ACJCSA is a new diagnostic image parameter for ACJO. METHODS ACJ samples were obtained from 35 patients with ACJO and 30 healthy individuals who underwent shoulder magnetic resonance (S-MR) imaging that revealed no evidence of ACJO. Oblique coronal, T2-weighted, fat-suppressed S-MR images were acquired at the ACJ level from the two groups. We measured the ACJCSA and the ACJ space width (ACJSW) at the ACJ on the S-MR images using our imaging analysis program. The ACJCSA was measured as the cross-sectional area of the ACJ. The ACJSW was measured as the narrowest point between the acromion and the clavicle. RESULTS The average ACJCSA was 39.88 ± 10.60 mm 2 in the normal group and 18.80 ± 5.13 mm 2 in the ACJO group. The mean ACJSW was 3.51 ± 0.58 mm in the normal group and 2.02 ± 0.48 mm in the ACJO group. ACJO individuals had significantly lower ACJCSA and ACJSW than the healthy individuals. Receiver operating characteristic curve analyses demonstrated that the most suitable ACJCSA cutoff score was 26.14 mm 2 , with 91.4% sensitivity and 90.0% specificity. CONCLUSION The optimal ACJSW cutoff score was 2.37 mm, with 88.6% sensitivity and 96.7% specificity. Even though both the ACJCSA and ACJSW were significantly associated with ACJO, the ACJCSA was a more sensitive diagnostic image parameter.

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Section: Discussionmentioning

confidence: 99%

“…Thus, positive associations regarding the incidence of rotator cuff tears and the severity of ACJ degeneration have been demonstrated. Clinically, the possibility of ACJ abnormalities is examined using the body cross-test and palpation[ 4 , 9 , 25 ]. The body cross-test is performed by elevating the affected arm on the same side.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of the acromioclavicular joint cross-sectional area as a diagnostic image parameter of acromioclavicular osteoarthritis

Joo¹,

Moon²,

Han³

et al. 2022

WJCC

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“…The superior margin of the remaining lateral clavicle is smoothed with a file to reduce any sharp bony ridge beneath the epidermis. Postoperative complications can include ACJ stiffness, heterotopic ossification, and infection [10]. Overresection of the distal clavicle can lead to ACJ instability [9, 10].…”

Section: Discussionmentioning

confidence: 99%

Bilateral Acromioclavicular Joint Subluxation in an Adolescent with Ehlers-Danlos Syndrome: Case Report and Literature Review

Colón

Padgett

Sanders

et al. 2022

Case Rep Orthop Res

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Bilateral acromioclavicular joint (ACJ) dislocation is a rare occurrence, with only one reported case in the literature published in 1984. We present the case of a 15-year-old male with Ehlers-Danlos syndrome (EDS) who presented with complaints of subsequent nontraumatic bilateral ACJ subluxations and pain. ACJ reconstruction via an open mini-Mumford procedure was performed on this patient on two separate occasions with successful outcomes. The patient demonstrated decreased pain and increased stability during the postoperative period. EDS is a rare collagen disorder that is usually characterized by abnormal skin elasticity, bleeding tendencies, and, most importantly for this case, joint hypermobility. It is important to have an elevated index of clinical suspicion for potential joint subluxations and injuries in patients with a known history of collagen disease.

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“…Acromioplasty was performed in the shoulder with significant preoperative radiographic evidence of acromial spur on the supraspinatus outlet or Rockwood tilt view or from the MRI. The acromioclavicular joint was resected 2 with patients having preoperative acromioclavicular joint tenderness and significant osteoarthritic change. The supraspinatus and infraspinatus were repaired using double-row suture-bridge technique in all cases using 1-2 medial-row anchor sutures (5.5-mm CrossFT-BC, ConMed-Linvatec, Largo, FL) and 1-2 lateral-row anchor sutures (4.5-mm PopLok Knotless Suture Anchors, ConMed-Linvatec, Largo, FL) depending on the tear size.…”

Section: Surgical Techniquesmentioning

confidence: 99%

Efficacy of postoperative drainage after arthroscopic rotator cuff repair: a randomized controlled trial

Apivatgaroon¹,

Ratanacharatroj²

2021

JSES International

Self Cite

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Background Arthroscopic rotator cuff repair is the standard treatment in patients with symptomatic reparable rotator cuff tear. It brings good to excellent postoperative outcomes. Postoperative suction drainage is the method to theoretically reduce postoperative shoulder swelling and hematoma formation, which is still commonly used in clinical practice, yet its efficacy remains unproven. Methods This is a nonblinded prospective randomized controlled study. A sample of 43 shoulders were simply randomized without replacement across drain and nondrain groups, allocated by sealed envelope before skin closures. The preoperative, intraoperative, and postoperative data were analyzed. The difference of oblique (O) and horizontal (H) shoulder circumference between before and after operation is the primary parameter indicating swelling and hematoma formation. The preoperative reliability of O and H dimensions were evaluated by 2 independent evaluators. The visual analog scale, estimated blood loss, and Disabilities of Arm, Shoulder, and Hand score were analyzed. Results There was no significant difference of circumference between drain and nondrain groups in both O and H methods. For method O, the mean difference between drain and nondrain groups at 24 hours was -0.25 (95% CI: -2.09 to 1.59, P = .783), at 1 week was -0.54 (95% CI: -2.05 to 0.96, P = .470), at 1 month was -0.39 (95% CI: -2.06 to 1.28, P = .639) and at 3 months was -0.01 (95% CI: -1.49 to 1.46, P = .987). Method H: Mean difference between groups at 24 hours was 0.29 (95% confidence interval [CI]: -0.61 to 1.20, P = .520), at 1 week was 0.004 (95% CI: -0.99 to 1.002, P = .993), at 1 month was -0.53 (95% CI: -1.62 to 0.56, P = .333), and at 3 months was -0.07 (95% CI: -0.91 to 0.77, P = .862). The preoperative O and H parameters showed strong to almost perfect agreement (intraclass correlation coefficient for A = 0.858 [95% CI: 0.738 to 0.923, P < .001], intraclass correlation coefficient for B = 0.955 [95% CI: 0.918 to 0.976, P < .001]). No significant difference of visual analog scale, estimated blood loss, and Disabilities of Arm, Shoulder, and Hand score was recorded between groups. Conclusion No difference was found between drain and nondrain placement for shoulder swelling, visual analog scale, estimated blood loss, and functional outcome in 3 months after surgery. Drain placement after arthroscopic rotator cuff repair is of unproven benefit in routine clinical practice.

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Arthroscopic Distal Clavicle and Medial Border of Acromion Resection for Symptomatic Acromioclavicular Joint Osteoarthritis

Cited by 10 publications

References 6 publications

Usefulness of the acromioclavicular joint cross-sectional area as a diagnostic image parameter of acromioclavicular osteoarthritis

Usefulness of the acromioclavicular joint cross-sectional area as a diagnostic image parameter of acromioclavicular osteoarthritis

Bilateral Acromioclavicular Joint Subluxation in an Adolescent with Ehlers-Danlos Syndrome: Case Report and Literature Review

Efficacy of postoperative drainage after arthroscopic rotator cuff repair: a randomized controlled trial

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