Complications After Arthroscopic Coracoclavicular Reconstruction Using a Single Adjustable–Loop-Length Suspensory Fixation Device in Acute Acromioclavicular Joint Dislocation

Shin, Sang-Jin; Kim, Nam Ki

doi:10.1016/j.arthro.2014.11.013

Cited by 108 publications

(98 citation statements)

References 23 publications

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“…Moreover, using the lateral portal as the secondary viewing portal facilitated the manipulation of the TightRope buttons from the anterior and posterior portals. A recent study of Shin and Kim 25) showed a complication rate of 44% in a case series with 18 patients after a single adjustable loop-length suspensory fixation for acute AC dislocation. They described one case of delayed distal clavicular fracture at the clavicular hole of the device, in addition to 3 cases of clavicular or coracoid button failures and 3 cases of clavicular bony erosion after a mean follow-up of 25.6 months.…”

Section: Discussionmentioning

confidence: 99%

All-arthroscopic, Guideless Single Suture-button Fixation of Acute Acromioclavicular Joint Dislocation: A Description of the Technique and Early Treatment Results

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Uzer

et al. 2017

Clinics in Shoulder and Elbow

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Background: The purpose of this study was to examine the clinical and radiological results of the all-arthroscopic, suture-button fixation technique to treat acute acromioclavicular (AC) joint separations. Methods: All patients with acute AC joint separations received all-arthroscopic, single suture-button (TightRope) procedure without a special guide. Postoperative Constant score (CS), pain level according to visual analogue scale, and range of motion (ROM) were evaluated. For radiological evaluation, coracoclavicular distances were measured bilaterally. Results: Between December 2010 and June 2012, 18 consecutive patients (4 women and 14 men; mean age, 29.3 years) with acute AC joint separations underwent surgical treatment after 6.4 days (range, 2-20 days) following the initial trauma. The average postoperative follow-up was 16.9 months. The mean CS was 92.4 (range, 84-96). The mean external rotation, forward flexion, and abduction were 75.8° (range, 50°-90°), 170° (range, 150°-180°), and 163.8° (range, 140°-180°), respectively. Five patients exhibited coracoclavicular ossifications. In two patients, superficial wound infections were successfully treated with antibiotic therapy. In one patient, a coracoid fracture was observed. No significant differences were found regarding pain, ROM, or strength parameters between both sides. The coracoclavicular distance was discovered to be approximately 2.8 mm greater on the affected side; however, this minimal reduction loss did not affect the functional results. Conclusions: The findings of this study suggests that all-arthroscopic treatment of AC joint separations using the single suture-button technique without a drill guide is safe, yielding good to excellent clinical results. (Clin Shoulder Elbow 2017;20(2):59-67)

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Section: Discussionmentioning

confidence: 99%

All-arthroscopic, Guideless Single Suture-button Fixation of Acute Acromioclavicular Joint Dislocation: A Description of the Technique and Early Treatment Results

Altıntaş

Yıldız

Uzer

et al. 2017

Clinics in Shoulder and Elbow

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“…This rate of loss of reduction is significantly higher than reported in double-bundle CC ligament reconstructions, which have demonstrated a 4.8% reduction loss after 2 years of follow-up. [2][3][4][5] To evaluate which fixation method was biomechanically superior, the authors used 8 cadaveric specimens and evaluated AC joint transition and rotational stability using a 3-dimensional system, after each of the 4 fixation methods. With regard to AC joint translation, the authors examined native and reconstructed AC joint anteroposterior (AP) and superoinferior translation using 10 and 15 N loads.…”

Section: See Related Article On Page 2983mentioning

confidence: 99%

Editorial Commentary: Double Bundle the Coracoclavicular Ligaments for Success: The More the Better?

Chahla

Cinque

2018

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Injuries to the acromioclavicular joint are common across all levels of sport and activity. Overall, a consensus exists regarding Rockwood grade I and II injuries (conservative approach) and Rockwood grades IV to VI (best treated surgically). However, grade III injuries are heterogeneous and thus respond differently to nonoperative and operative treatment. Regardless of the acromioclavicular injury grade, these are widely prevalent injuries, and there is a lack a consensus as to which operative fixation methods yield the best outcomes for patients. Although K-wires and plates were historically used to achieve rigid fixation, recent evidence supports the use of soft tissue grafts to reconstruct the coracoclavicular ligaments and restore vertical and anteroposterior and rotational stability with a more biological approach.

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“…10,[13][14][15][16][17][18][19][20][21][22] For instance, CC screw fixation is the strongest type of fixation. Despite this, there are numerous complications from its use including iatrogenic fracture, hardware migration, and the need for hardware removal with remaining stress risers.…”

Section: Performing Final Closurementioning

confidence: 99%

“…[5][6][7][8] Arthroscopic cortical fixation techniques are less invasive but do not anatomically reconstruct the acromioclavicular ligaments. 9,10 Furthermore, these often need to be performed acutely unless a graft is used. The Weaver-Dunn technique involves transfer of the coracoacromial ligament to the distal clavicle.…”

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confidence: 99%

Acromioclavicular Joint Reconstruction

Scillia

Cain

2015

Arthroscopy Techniques

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Our technique for acromioclavicular joint reconstruction provides a variation on coracoclavicular ligament reconstruction to also include acromioclavicular ligament reconstruction. An oblique acromial tunnel is drilled, and the medial limb of the gracilis graft, after being crossed and passed beneath the coracoid and through the clavicle, is passed through this acromial tunnel and sutured to the trapezoid graft limb after appropriate tensioning. Tenodesis screws are not placed in the bone tunnels to avoid graft fraying, and initial forces on the graft are offloaded with braided absorbable sutures passed around the clavicle.

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Complications After Arthroscopic Coracoclavicular Reconstruction Using a Single Adjustable–Loop-Length Suspensory Fixation Device in Acute Acromioclavicular Joint Dislocation

Cited by 108 publications

References 23 publications

All-arthroscopic, Guideless Single Suture-button Fixation of Acute Acromioclavicular Joint Dislocation: A Description of the Technique and Early Treatment Results

All-arthroscopic, Guideless Single Suture-button Fixation of Acute Acromioclavicular Joint Dislocation: A Description of the Technique and Early Treatment Results

Editorial Commentary: Double Bundle the Coracoclavicular Ligaments for Success: The More the Better?

Acromioclavicular Joint Reconstruction

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