Operative treatment of chronic acromioclavicular dislocation

Larsen, Erik Hviid; Petersen, Vivian Stausholm

doi:10.1016/0020-1383(87)90388-3

Cited by 23 publications

(11 citation statements)

References 6 publications

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“…This injury is frequent in young and athletically active persons who require a return to sports activity and overhead work without complaints. Reported success rates of surgical treatment in chronic cases are slightly lower [12,18,28,29], but our medium-term findings demonstrate that the modified Weaver-Dunn technique is a useful and reliable method and can be recommended when surgery is indicated for chronic, grade III AC dislocations.…”

Section: Discussionmentioning

confidence: 93%

“…Some authors propose using several synthetic materials for this purpose to avoid the application of a metallic fixation and its subsequent removal [5,13,19,28], but it is known that bone erosion or clavicular amputation can take place [14]. The coracoclavicular screw technique is a widely accepted and proven method which gives a good stability and therefore results in accelerated rehabilitation [3,12,18,24]. Screw removal is very simple and can be carried out under local anesthesia.…”

Section: Discussionmentioning

confidence: 99%

“…

IntroductionMany surgical procedures have been proposed for treating chronic, symptomatic acromioclavicular (AC) joint dislocation of Tossy grade III [8,12,18,21,23,24, 28], but there is as yet no consensus over the optimal therapy. One of the most important aspects in planning an adequate treatment is to determine the grade of the injury and the state of the injured coracoclavicular ligaments.

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confidence: 99%

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Surgical treatment of chronic acromioclavicular joint dislocation by modified Weaver-Dunn procedure

Pavlik

Csépai

Hidas

2001

Knee Surg Sports Traumatol Art

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We present our technique for surgically treating Tossy III acromioclavicular joint dislocation, discuss the indications for various procedures, and evaluate our postoperative results. We operated on 17 patients suffering from chronic acromioclavicular instability after such dislocation using a modified Weaver-Dunn procedure, in which there is no lateral clavicular end resection, the coracoacromial ligament graft is sutured to the inferior part of the clavicle by transosseal sutures, and a Bosworth coracoclavicular screw is used to protect the graft postoperatively for 8 weeks. After a mean of 37 months we evaluated shoulder function by the Constant score and the subjective and radiological results. Mean Constant score was 91.9% (74-100%); it was 80-90% in 5 patients and above 90% in 11. One patient had screw loosing after the operation and suffered partial loss of reduction and discomfort during shoulder loading. All patients but one returned to work, and all but one have returned to their preoperative activity at the same level. Subjectively, there were 11 excellent and 6 good results. Compared to the contralateral uninjured side, radiography showed anatomical reposition in the vertical plane in 9 cases, slight loss of reduction in 6 (difference in the distance between the inferior border of the acromion and the clavicle is 2-4 mm), and partial loss of reduction in 2 (4-8 mm). We recommend the modified Weaver-Dunn procedure for surgical treatment of chronic, Tossy grade III acromioclavicular joint dislocations as it provides good functional and subjective results. Our modification is indicated mainly for young patients because posttraumatic arthrosis occurs more frequently in elderly patients, making clavicular end resection necessary.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Surgical treatment of chronic acromioclavicular joint dislocation by modified Weaver-Dunn procedure

Pavlik

Csépai

Hidas

2001

Knee Surg Sports Traumatol Art

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“…Since the original technique was described, numerous variants of the Weaver-Dunn procedure have been developed. 1 , 2 , 9 , 11 , 13 , 14 , 15 , 18 , 19 , 20 , 21 , 22 , 23 , 25 , 26 , 27 , 33 , 34 Many of these variants incorporated either AC or CC transfixation methods to protect the reconstruction during healing. Indeed, biomechanical studies have shown that isolated CA ligament transfers are significantly weaker than the native CC ligaments, and augmentation techniques can help restore time-zero strength to the native state.…”

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confidence: 99%

Anatomic reconstruction of acromioclavicular joint dislocations using allograft and synthetic ligament

et al. 2020

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Background Acromioclavicular (AC) separations are commonly seen shoulder injuries. Numerous surgical reconstruction techniques have been described. In this study, we present a series of patients who underwent an anatomic reconstruction using a synthetic ligament and allograft construct. Methods We performed a retrospective review of patients with type IV or V AC separations who underwent primary or revision AC reconstruction with a luggage-tag synthetic ligament and a semitendinosus allograft placed through the anatomic insertion sites of the coracoclavicular ligaments. Patient-reported outcomes, as well as complication rates, were recorded at a minimum 2-year follow-up. Results Ten patients with a mean age of 44.2 ± 14.9 years were included in the study. The mean Disabilities of the Arm, Shoulder and Hand score was 15.5 ± 15.4; mean Single Assessment Numeric Evaluation score, 81.8 ± 12.1; mean Simple Shoulder Test score, 11.4 ± 1.1; mean American Shoulder and Elbow Surgeons score, 84.6 ± 15.7; mean Constant score, 82.5 ± 11.6; and mean visual analog scale score, 2 ± 2.6. Conclusion The technique using a luggage-tag synthetic ligament along with an anatomic allograft coracoclavicular ligament reconstruction is a safe, effective alternative to other techniques described in the literature.

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“…High grade AC injuries, with complete disruption of the coracoclavicular (CC) ligaments, have been those considered for surgical intervention [3][4]. A variety of surgical procedures have been proposed over the years [5][6][7][8][9][10][11]. Complications after AC surgery are relatively common with the most common being loss of reduction.…”

Section: Introductionmentioning

confidence: 99%

Recommendations for Optimizing Acromioclavicular Fixation Success with the Tight Rope Device

Simonian¹

2017

MOJOR

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Purpose: To determine if the TightRope device (Arthrex Naples, FL) for fixation of acromioclavicular (AC) separations can create an environment for biologic healing of the coracoclavicular (CC) ligaments.Methods: Twenty-five male subjects, sustained Grade V AC separations. All patients had AC reconstruction with the TightRope device (Arthrex, Naples, FL). The time from the injury to surgical fixation averaged 13 days.Results: Twenty-one of 25 patients had an anatomic reduction of their AC joint. Four were reduced to a near-anatomic (within 2mm) reduction. At final followup, four (16%) patients maintained their anatomic reduction. These four patients underwent surgery at an average of 11 days after the date of injury and had an average age of 25 years. Thirteen (52%) patients displaced to a grade II level (Rockwood classification). These patients averaged 10 days from the date of injury to the date of surgery and had an average age of 39 years. Eight (32%) of the 25 had displaced back to a grade III level (Rockwood classification). These patients averaged 18 days from the date of injury until date of surgery and had an average age of 35 years. All 25 patients described a subjective improvement regardless of displacement. Conclusion:There is a high rate of loss of reduction when using the TightRope (Arthrex, Naples, FL) device. When this device is employed, it should be done as quickly as possible after injury. When the time from injury to surgery exceeds 11 days, loss of reduction seems to be greater. There may be a correlation between older age and a more significant loss of reduction regardless of the acuity of fixation. Level of evidence:IV.

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Operative treatment of chronic acromioclavicular dislocation

Cited by 23 publications

References 6 publications

Surgical treatment of chronic acromioclavicular joint dislocation by modified Weaver-Dunn procedure

Surgical treatment of chronic acromioclavicular joint dislocation by modified Weaver-Dunn procedure

Anatomic reconstruction of acromioclavicular joint dislocations using allograft and synthetic ligament

Recommendations for Optimizing Acromioclavicular Fixation Success with the Tight Rope Device

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