Midterm results of coracoclavicular stabilization with double augmentation for acute acromioclavicular dislocation

Abstract

IntroductionNumerous techniques have been introduced for the treatment of acute acromioclavicular (AC) joint dislocation. We aim to report the midterm results of coracoclavicular (CC) stabilization with double augmentation for the acute AC joint dislocation.Case descriptionForty-three patients who underwent surgery for acute AC joint dislocation were followed up for an average of 59.6 months (range 40–97). The study composed of two treatment groups: group S, with 25 patients, in whom two suture anchors were used; and group B, with 18 patients, in whom a suture anchor and a double flip-button device were used, however the techniques in both groups are based on the same principle which is double augmentation. Postoperative evaluations were made retrospectively, clinically, and radiographically.Discussion and EvaluationAt the last follow-up, the mean Constant score was 91.2 (range 74–100) and the UCLA scale was 31.4 (range 24–35). The overall ratio of the CC distance in the injured shoulder to that in the uninjured shoulder, expressed as a percentage, significantly decreased, to 93.4 ± 22.7 %, immediate postoperatively, and significantly increased, to 113.8 ± 23.4 %, at the final follow-up. Complete reduction of the AC joint was achieved in 34 patients (79.1 %), and 8 patients (18.6 %) exhibited a slight loss of reduction, although their functional outcomes were good.ConclusionsThe results of this study provide evidence that double augmentation is effective in the treatment of acute AC dislocation.Level of evidenceTherapeutic study, case series, Level IV.

The frequency of reduction loss after arthroscopic fixation of acute acromioclavicular dislocations using a double-button device, and its effect on clinical and radiological results

“…Mean time from injury to surgery was 6.8 ± 3.8 days (range, 2-14). The mean time to return to work was 11.2 ± 2.9 weeks (range, [8][9][10][11][12][13][14][15][16][17][18][19][20]. When trauma mechanisms are examined, 15 patients were injured while doing sports, 14 patients were injured after a traffic accident, 5 patients were injured after falling from height and 2 patients were injured during a fight.…”

“…In order to solve complications such as reduction loss, techniques including opening of a second tunnel [9], supporting the existing tunnel with anchor to the coracoid [10] and using tendon graft [11] have been proposed by different authors. However, none of these techniques have been widely accepted.…”

Coracoclavicular Space Widening on Radiographs After Arthroscopic Stabilization With Suspensory Fixation Does Not Affect Athletic Performance

“…We used the The loss of reduction after AC reconstruction using suspensory fixation devices has been reported frequently in the literature. 7,9,11,13,14,16,24,25 While many researchers attempted to investigate the athletic performance following AC reconstruction, the effect of loss of reduction of the AC joint on the athletic performance of the patients was not reported in the literature before. 8,19,26,27 In a systematic review done by Verstift et al, 19 they reviewed 12 articles that evaluated the return to the preinjury level of sport after a repair of Rockwood types III to VI dislocations, with a total number of patients of 498, of which 462 patients were engaged in sports activities.…”

Reconstruction of Coracoclavicular Ligament with Endobutton and Sutures to Stabilize Acromioclavicular Joint: A Retrospective Clinical Study and Finite Element Analysis

“…However, with the in-depth anatomical study of the stable structure of the acromioclavicular joint, some researchers believe that double-bundle anatomical reconstruction is the key factor for postoperative stability of the acromioclavicular joint and it is necessary to reconstruct the two branches of the coracoclavicular ligament: the trapezoid ligament and the conus ligament. Some of these researchers used double-bundle reconstruction with two tunnels on both clavicle and coracoid process, or used autogenous tendon to bypass the base of coracoid process to form double-bundle ligament (26), which not only can increase the vertical stability of acromioclavicular joint after surgery, but also can enhance the horizontal stability of acromioclavicular joint to some extent (27,28). However, it has been proposed that coracoid dualtunnel may greatly increase the risk of iatrogenic fracture and injury of brachial plexus nerve and blood vessels (22).…”