ISAKOS Upper Extremity Committee Consensus Statement on the Need for Diversification of the Rockwood Classification for Acromioclavicular Joint Injuries

Beitzel, Knut; Mazzocca, Augustus D.; Bak, Klaus; Itoi, Eiji; Kibler, W. Ben; Mirzayan, Raffy; Imhoff, Andreas B.; Calvo, Emílio; Arce, Guillermo; Shea, Kevin P.

doi:10.1016/j.arthro.2013.11.005

Cited by 228 publications

(204 citation statements)

References 13 publications

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“…These range from treating the correct patient based on the perfect diagnosis as well as finding the optimal time point and procedure for surgical treatment. 9 Although our early results are encouraging, investigations with long-term follow-up will be necessary to show the value and possible advantages of the described procedure. ER, external rotation; IR, internal rotation.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopically Assisted Treatment of Acute Dislocations of the Acromioclavicular Joint

Braun

Beitzel

Buchmann

2015

Arthroscopy Techniques

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Arthroscopically assisted treatments for dislocations of the acromioclavicular joint combine the advantages of exact and visually controlled coracoid tunnel placement with the possibility of simultaneous treatment of concomitant injuries. The clinical results of previous arthroscopically assisted techniques have been favorable at midterm and long-term follow-up. The presented surgical technique combines the advantages of arthroscopically positioned coracoclavicular stabilization with an additional suture cord cerclage of the acromioclavicular joint capsule for improved horizontal stability.

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Section: Discussionmentioning

confidence: 99%

Arthroscopically Assisted Treatment of Acute Dislocations of the Acromioclavicular Joint

Braun

Beitzel

Buchmann

2015

Arthroscopy Techniques

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“…1,10 Interestingly, the ISAKOS Upper Extremity Committee has provided recently a more specific classification of this shoulder pathologies to enhance the knowledge of, and clinical approach to, these injuries. 11 They suggested the addition of type IIIA (stable ACJ without overriding of the clavicle on the cross-body adduction view and without significant scapular dysfunction) and type IIIB (unstable ACJ with therapy-resistant scapular dysfunction and an overriding clavicle on the cross-body adduction view) injuries to a modified Rockwood classification.…”

Section: Discussionmentioning

confidence: 99%

Current practice in the management of Rockwood type III acromioclavicular joint dislocations—National survey

Dömös

Dunne

et al. 2017

Journal of Orthopaedic Surgery

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Purpose: Our aim was to conduct this survey among consultant shoulder surgeons in the United Kingdom to document the current management of Rockwood type III acromioclavicular joint (ACJ) injuries. Methods: British Elbow and Shoulder Society Research Committee-approved online survey was used and 137 responses were collected within 3 months. Results: One hundred percent of responders would treat type III injuries conservatively initially. Routine physiotherapy would be offered by 86% of surgeons. The patient's factors that influence the decision to consider surgery are pre-injury functional demand, current functional deficit, pain and patient request for surgery. Across all groups the mean time to surgical intervention from injury was 3.8 months. About 45% of all consultants would use the same technique for all cases and there were differences between the varieties of techniques used by surgeons, depending on their degree of experience. LockDown was the most widely used technique in all groups of patients. This was followed by Ligament Augmentation & Reconstruction System (LARS), hook plate and Arthroscopic TightRope/DogBone technique for acute injuries. LARS, modified Weaver-Dunn and ACJ resection were used most commonly after LockDown for delayed cases. Conclusion: Our survey revealed the current trends in clinical practice to treat symptomatic Rockwood type III ACJ injuries, but it also confirmed the controversial and complex management differences, which vary among shoulder surgeons in the United Kingdom.

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“…According to their algorithm, type III injuries should mainly be treated conservatively with a reevaluation in 3 to 6 weeks, with consideration to surgical therapy in case of persistent instability. 4) Beitzel et al 5) showed a lack of evidence to support early versus delayed surgical interventions as well as anatomic versus non-anatomic surgical techniques in the treatment of patients with AC joint dislocations, despite the previously described 151 techniques for operative reconstruction of the AC in the literature.…”

Section: Introductionmentioning

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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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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ISAKOS Upper Extremity Committee Consensus Statement on the Need for Diversification of the Rockwood Classification for Acromioclavicular Joint Injuries

Cited by 228 publications

References 13 publications

Arthroscopically Assisted Treatment of Acute Dislocations of the Acromioclavicular Joint

Arthroscopically Assisted Treatment of Acute Dislocations of the Acromioclavicular Joint

Current practice in the management of Rockwood type III acromioclavicular joint dislocations—National survey

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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