Arthroscopically assisted stabilization of chronic bidirectional acromioclavicular joint instability using a low-profile implant and a free tendon graft

Dittrich, Michael; Wirth, Barbara; Freislederer, Florian; Bellmann, Frederik; Scheibel, Markus

doi:10.1007/s11678-020-00576-y

Cited by 5 publications

(5 citation statements)

References 6 publications

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“…Therefore, the higher failure rates for this device need to be carefully interpreted. However, recent literature using this reconstruction system recommends a tension load of 80–120 N [ 5 , 11 ] which was assured in this study. It also needs to be recognized that the Levene’s test disproved the equality of error variances for three measurement points (50% spongiosa of the clavicula as well as superior and inferior cortex of the coracoid).…”

Section: Discussionmentioning

confidence: 93%

“…Moreover, this study could not find a difference in tunnel widening between the differently shaped suture devices (tape and wire). To prevent tunnel widening due to frictional damage of the high-tensile sutures, a new Low Profile AC Repair System device was recently introduced in the context of acute and chronic AC joint instability [ 5 , 11 ]. Based on the results of this study, this device and its superior clavicle insert button which is inserted 5 mm unicortically in the superior clavicle does not inhibit tunnel widening, since the origin of clavicular tunnel widening was observed in the inferior parts.…”

Section: Discussionmentioning

confidence: 99%

“…According to the manufacturer’s instructions, the suture tensioning instrument should be used to check mark 50—which accounts to 220 N if compared to a load cell. During the first implantation with this tensioner, it was noticed that this force would be too high—especially taking into consideration that the recent literature advises a tensioning force of 80–120 N specifically for this device [ 5 , 11 ]. Therefore, the tensioner was not used in the following samples.…”

Section: Methodsmentioning

confidence: 99%

“…This may contribute to a loss of reduction and an increased fracture risk over time [ 2 , 7 , 8 , 23 , 28 , 29 ]. Recent implant development aims to reduce bone tunnel widening using an unicortical insert button (Low Profile AC Repair System) [ 5 ]. Still, this hypothesis has not been proven and the specific characteristics of postoperative tunnel widening remain unclear.…”

Section: Introductionmentioning

confidence: 99%

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Acromioclavicular joint suture button repair leads to coracoclavicular tunnel widening

Dalos

Huber

Wichern

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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Purpose Biomechanical evaluation of three different suture button devices used in acromioclavicular joint repair and analysis of their effect on post-testing tunnel widening. Methods Eighteen human shoulder girdles were assigned into three groups with a similar mean bone mineral density. Three different single-tunnel acromioclavicular repair devices were tested: (1) AC TightRope® with FiberWire; (2) AC Dog Bone™ Button with FiberTape; (3) Low Profile AC Repair System. Biomechanical testing was performed simulating the complex movement of the distal clavicle as follows. A vertical load of 80 N was applied continuously. The rotation of the clavicle about its long axis was set at 10° anterior and 30° posterior for 2500 cycles at 0.25 Hz. The horizontal translation of the clavicle was set at 6 mm medial and 6 mm lateral for 10,000 cycles at 1 Hz. The coracoclavicular distance was measured before and after testing. After testing, each sample underwent micro-CT analysis. Following 3D reconstruction, the area of the bone tunnels was measured at five defined cross sections. Results In TightRope® and Dog Bone™ groups, all samples completed testing, whereas in the Low Profile group, three out of six samples showed system failure. The mean absolute difference of coracoclavicular distance after testing was significantly greater in the Low Profile group compared to TightRope® and Dog Bone™ groups (4.3 ± 1.3 mm vs 1.9 ± 0.7 mm vs 1.9 ± 0.8 mm; p = 0.001). Micro-CT analysis of the specimens demonstrated significant tunnel widening in the inferior clavicular and superior coracoid regions in all three groups (p < 0.05). Conclusion Significant tunnel widening can be observed for all devices and is primarily found in the inferior parts of the clavicle and superior parts of the coracoid. The Low Profile AC Repair System showed inferior biomechanical properties compared to the AC TightRope® and AC Dog Bone™ devices. Therefore, clinicians should carefully select the type of acromioclavicular repair device used and need to consider tunnel widening as a complication.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Acromioclavicular joint suture button repair leads to coracoclavicular tunnel widening

Dalos

Huber

Wichern

et al. 2022

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

show abstract

“…Im Fall einer erhöhten Frakturgefahr oder zur allgemeinen Reduktion der Frakturgefahr, kann das Verfahren in genannter Technik modifiziert werden[41].Die Ergebnisse nach minimalinvasiver Therapie der chronischen ACG-Sprengung werden in ▶ Tab. 3 dargestellt.…”

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