Minimally Invasive Coracoclavicular Ligament Reconstruction With a Flip-Button Technique (MINAR)

Roßlenbroich, Steffen; Schliemann, Benedikt; Schneider, Kristian Nikolaus; Metzlaff, Sebastian; Koesters, Clemens; Weimann, André; Petersen, Wolf; Raschke, Michael J.

doi:10.1177/0363546515579179

Cited by 42 publications

(48 citation statements)

References 29 publications

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“…Present study showed, that mini-open operative ACLC treatment was required in 21.5 % of acute ACJ dislocations to achieve anatomical reduction. This finding might at least partly explain the high rates of horizontal ACJ instability following closed techniques of acute ACJ reconstruction [13, 17, 24, 28, 30, 33]. Additional operative ACLC repair might support anatomical ACLC healing, if sufficient biomechanical augmentation is provided during the phase of healing [10].…”

Section: Discussionmentioning

confidence: 99%

“…The superior ACLC functions as the major horizontal stabilizer of the ACJ [3, 5, 8, 16]. Insufficient superior ACLC healing may contribute to persistent horizontal ACJ instability, which is reported in up to 50 % of cases following both arthroscopic and open reconstruction of acute ACJ dislocations [13, 17, 24, 33]. Horizontal ACJ instability represents a clinically relevant issue, since several studies showed an association with inferior functional outcome [13, 19, 30].…”

Section: Introductionmentioning

confidence: 99%

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Injury patterns of the acromioclavicular ligament complex in acute acromioclavicular joint dislocations: a cross-sectional, fundamental study

Maier

Jaeger

Reising

et al. 2016

BMC Musculoskelet Disord

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BackgroundHorizontal instability impairs clinical outcome following acute acromioclavicular joint (ACJ) reconstruction and may be caused by insufficient healing of the superior acromioclavicular ligament complex (ACLC). However, characteristics of acute ACLC injuries are poorly understood so far. Purposes of this study were to identify different ACLC tear types, assess type-specific prevalence and determine influencing cofactors.MethodsThis prospective, cross-sectional study comprised 65 patients with acute-traumatic Rockwood-5 (n = 57) and Rockwood-4 (n = 8) injuries treated operatively by means of mini-open ACJ reduction and hook plate stabilization. Mean age at surgery was 38.2 years (range, 19–57 years). Standardized pre- and intraoperative evaluation included assessment of ACLC tear patterns and cofactors related to the articular disc, the deltoid-trapezoidal (DT) fascia and bony ACJ morphology. Articular disc size was quantified as 0 = absent, 1 = remnant, 2 = meniscoid and 3 = complete.ResultsAll patients showed complete ruptures of the superior ACLC, which could be assigned to four different tear patterns. Clavicular-sided (AC-1) tears were observed in 46/65 (70.8 %), oblique (AC-2) tears in 12/65 (18.5 %), midportion (AC-3) tears in 3/65 (4.6 %) and acromial-sided (AC-4) tears in 4/65 (6.1 %) of cases. Articular disc size manifestation was significantly (P < .001) more pronounced in patients with AC-1 tears (1.89 ± 0.57) compared to patients with AC-2 tears (0.67 ± 0.89). Other cofactors did not influence ACLC tear patterns. ACLC dislocation with incarceration caused mechanical impediment to anatomical ACJ reduction in 14/65 (21.5 %) of cases including all Rockwood-4 dislocations. Avulsion “in continuity” was a consistent mode of failure of the DT fascia. Type-specific operative strategies enabled anatomical ACLC repair of all observed tear types.ConclusionsAcute ACLC injuries follow distinct tear patterns. There exist clavicular-sided (AC-1), oblique (AC-2), midportion (AC-3) and acromial-sided (AC-4) tears. Articular disc size was a determinant factor of ACLC tear morphology. Mini-open surgery was required in Rockwood-4 and a relevant proportion of Rockwood-5 dislocations to achieve both anatomical ACLC and ACJ reduction. Type-specific operative repair of acute ACLC tears might promote biological healing and lower rates of horizontal ACJ instability following acute ACJ reconstruction.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Injury patterns of the acromioclavicular ligament complex in acute acromioclavicular joint dislocations: a cross-sectional, fundamental study

Maier

Jaeger

Reising

et al. 2016

BMC Musculoskelet Disord

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“…Furthermore, Rosslenbroich and colleagues [16] observed a good clinical outcome regarding 96 patients who had undergone AC reconstruction with a fixation button (Fliptack).…”

Section: Discussionmentioning

confidence: 99%

A Novel Surgical Technique for Fixation of Recurrent Acromioclavicular Dislocations: AC Dog Bone Technique in Combination with Autogenous Semitendinosus Tendon Graft

Holweg

Pichler

Gruber

et al. 2017

Case Reports in Medicine

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Various surgical techniques have been described for the fixation of acromioclavicular (AC) dislocations. However, recurrent dislocation is one of the main complications associated with the majority of these techniques. We report a case of postoperative AC joint redislocation. In order to overcome recurrent dislocation after revision surgery, a reconstruction of the conoid and trapezoid ligament with the use of a free tendon graft in combination with a FiberTape was provided within a novel surgical technique. After 12 months, the patient was very satisfied with the functional outcome. The patient achieved excellent results in the Constant (98 points), SPADI (0 points), and QuickDASH score (0 points). The described technique results in an anatomic reconstruction of the AC joint. The nonrigid nature of the intervention seems to restore the normal arthrokinematics by reconstructing the coracoclavicular ligaments with an autograft which is then protected by the AC Dog Bone artificial ligaments during the healing period. The arthroscopic approach to the AC joint with minimal exposure reduces the risks and complications of the intervention. This is the first case in literature that utilizes the artificial dog bone ligament securing the autograft in an anatomic AC reconstruction.

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“…Acromioclavicular joint (ACJ) dislocation is a common injury among young people between 20 and 40 years old who practice sports, and it has an incidence of between 9% and 17% of all shoulder injuries [1][2][3][4][5][6]. The pattern of this trauma is a direct force to the acromion with the arm in an adducted position [7].…”

Section: Introductionmentioning

confidence: 99%

The Relationship Between the Clinical and Radiological Findings and the Outcomes of Early Surgical Treatment After Tossy Type III Acromioclavicular Joint Dislocation

Masionis

Bobina

Ryliškis

2020

Cureus

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Background Acromioclavicular joint (ACJ) dislocation is a common injury among young and physically active persons. Evaluating surgical outcomes clinically and radiographically is widely accepted, but it is not known which clinical tests or radiological indicators are the most important. Our hypothesis is that there is a significant correlation between clinical and radiological findings and outcomes after the early surgical treatment of Tossy type III ACJ dislocation.

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Minimally Invasive Coracoclavicular Ligament Reconstruction With a Flip-Button Technique (MINAR)

Cited by 42 publications

References 29 publications

Injury patterns of the acromioclavicular ligament complex in acute acromioclavicular joint dislocations: a cross-sectional, fundamental study

Injury patterns of the acromioclavicular ligament complex in acute acromioclavicular joint dislocations: a cross-sectional, fundamental study

A Novel Surgical Technique for Fixation of Recurrent Acromioclavicular Dislocations: AC Dog Bone Technique in Combination with Autogenous Semitendinosus Tendon Graft

The Relationship Between the Clinical and Radiological Findings and the Outcomes of Early Surgical Treatment After Tossy Type III Acromioclavicular Joint Dislocation

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