Arthroscopically Assisted Reconstruction of Acute Acromioclavicular Joint Dislocations: Anatomic AC Ligament Reconstruction With Protective Internal Bracing—The “AC-RecoBridge” Technique

Izadpanah, Kaywan; Jaeger, Martin; Ogon, Peter; Südkamp, Norbert P.; Maier, Dirk

doi:10.1016/j.eats.2015.01.012

Cited by 28 publications

(35 citation statements)

References 12 publications

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“…In the beginning, arthroscopically-assisted techniques only focused on the restoration of the CC ligament complex using strong synthetic suture material and cortical fixation buttons. 31 However, it was realized later that CC repair alone does not provide proper stability; additional stability was achieved by reconstructing the AC ligament complex to a certain extent. It should be kept in mind that all described arthroscopic techniques have reported pitfalls, including implant migration, need for implant removal, failure of reduction and fracture of coracoid and clavicle.…”

Section: Arthroscopic Techniquementioning

confidence: 99%

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: Arthroscopic Techniquementioning

confidence: 99%

Acromioclavicular joint injuries: diagnosis, classification and ligamentoplasty procedures

2018

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“…Therefore, recent biomechanical and clinical studies have advocated for reconstruction or repair of both the CC and AC capsule for stabilization. [4][5][6][7][8][9][10] The acromioclavicular ligament complex (ACLC) has been reported as the primary posterior stabilizer of the AC joint. [11][12][13][14] A previous biomechanical study demonstrated that dissection of the entire ACLC (with intact CC ligaments) reduced the resistance force of the AC joint against posterior translation to less than 25% when compared with the native ligament complex.…”

Section: Introductionmentioning

confidence: 99%

Reconstruction of the Acromioclavicular Ligament Complex Using Dermal Allograft: A Biomechanical Analysis

Morikawa

Mazzocca

Obopilwe

et al. 2020

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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“…The use of internal bracing has previously been described only as a protective augmentation after a ligament repair for a chronic soft tissue injury. 8 , 11 , 14 , 25 In this study, although protecting the acute, anterior SCJ ligamentous tear with internal bracing alone, and not repairing the tear, may have allowed it to heal, we did not consider this an option. The surgical exposure required to insert an internal brace involves opening up the medial and lateral ends of the capsular ligament, and we believed it would be inappropriate to not undertake a repair or plication of any associated capsular damage at the same time.…”

Section: Discussionmentioning

confidence: 94%

“…Third, internal bracing has been used successfully to augment various types of ligament repairs around the ankle, knee, and acromioclavicular joint. 8 , 11 , 14 , 25 Internal bracing acts as a secondary stabilizer to reinforce the repair, allowing for a quicker return to sport and potentially helping to resist injury and prevent recurrence. The additional advantage of using BioComposite anchors is that over time, they will be completely replaced by the surrounding bone.…”

Section: Discussionmentioning

confidence: 99%

Treatment of First-Time Traumatic Anterior Dislocation of the Sternoclavicular Joint With Surgical Repair of the Anterior Capsule Augmented With Internal Bracing

Tytherleigh-Strong

Pecheva

Titchener

2018

Orthopaedic Journal of Sports Medicine

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Background:Traumatic anterior dislocations of the sternoclavicular joint (SCJ) are rare. Although they can usually be treated by a closed reduction, the reported subsequent recurrence rate is 50%.Purpose:To determine whether further instability after first-time traumatic anterior dislocation would be prevented by a minimally invasive open repair of the anterior SCJ capsule, augmented with internal bracing.Study Design:Case series; Level of evidence, 4.Methods:Open repair of the anterior SCJ capsule was completed on a series of patients who had sustained a first-time traumatic anterior dislocation of the SCJ. Patients with preexisting SCJ instability and recurrent dislocations were excluded. Through a transverse incision, the anterior SCJ capsule was repaired and plicated by use of sutures. The repair was then protected by use of an internal brace, bridging between the sternum and the medial end of the clavicle.Results:Six patients (4 males, 2 females) with a mean age of 28.3 years were included. Four patients underwent surgery within 4 weeks of their dislocation, and 2 patients had ongoing symptoms of instability but had not had a further dislocation. The median follow-up was 28.2 months (range, 24-35 months). At the most recent follow-up, none of the patients had sustained further dislocation or episode of instability, and their SCJs appeared stable. The mean abbreviated Disabilities of the Arm, Shoulder and Hand (QuickDASH) score was 2.3 (range, 0-4.5).Conclusion:The medium-term results of this case series suggest that after first-time dislocation, surgical repair of the anterior SCJ capsule augmented with internal bracing can prevent recurrent instability. This may be an attractive option for individuals involved in higher risk activities, as the operative management of recurrent anterior SCJ instability usually requires a figure-of-8 tendon reconstruction, which carries a significantly higher morbidity.

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Arthroscopically Assisted Reconstruction of Acute Acromioclavicular Joint Dislocations: Anatomic AC Ligament Reconstruction With Protective Internal Bracing—The “AC-RecoBridge” Technique

Cited by 28 publications

References 12 publications

Acromioclavicular joint injuries: diagnosis, classification and ligamentoplasty procedures

Acromioclavicular joint injuries: diagnosis, classification and ligamentoplasty procedures

Reconstruction of the Acromioclavicular Ligament Complex Using Dermal Allograft: A Biomechanical Analysis

Treatment of First-Time Traumatic Anterior Dislocation of the Sternoclavicular Joint With Surgical Repair of the Anterior Capsule Augmented With Internal Bracing

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