Restoration of horizontal stability in complete acromioclavicular joint separations: surgical technique and preliminary results

Abstract

BackgroundOur purpose was to investigate the clinical efficacy of arthroscope-assisted acromioclavicular ligament reconstruction in combination with double endobutton coracoclavicular ligament reconstruction for the treatment of complete acromioclavicular joint dislocation.MethodsDuring the period from February 2010 to October 2012, ten patients with Rockwood types IV and V acromioclavicular joint dislocation were hospitalized and nine were treated with acromioclavicular ligament reconstruction combined with double endobutton of coracoclavicular ligament reconstruction. The improvement in shoulder functions was assessed using a Constant score and visual analog scale (VAS) system.ResultsThe mean follow-up period was 33.6 ± 5.4 months. The mean Constant scores improved from 25.2 ± 6.6 preoperatively to 92.4 ± 6.5 postoperatively, while the mean VAS score decreased from 5.9 ± 1.4 to 1.2 ± 0.9; significant differences were observed. The final follow-up revealed that excellent outcomes were achieved in eight patients and good outcome in two patients.ConclusionArthroscope-assisted acromioclavicular ligament reconstruction in combination with double endobutton of coracoclavicular ligament reconstruction is an effective approach for treatment of acute complete acromioclavicular joint dislocation.

Treatment of Rockwood type III acromioclavicular joint dislocation using autogenous semitendinosus tendon graft and endobutton technique

“…The mobile side of the hook plate underneath the acromion may cause symptoms of persistent pain and restriction in movement by acromial erosion and damaging the supraspinatus tendon. 9 , 21 Long-term retention of the plate may lead to acromial osteolysis or fracture, which implies that a second surgery is required to remove the plate after 12 weeks when the ligaments are healed. Kienast et al 7 achieved successful results using the hook plate in 313 patients of Rockwood type III–V AC joint dislocation, while all patients reported pain or discomfort with the hook plate.…”

“…The objective was to prevent complications, especially shoulder pain by minimizing recurrent displacement and joint irritation, and to avoid soft tissue reactions and traumatic arthritis. 19 , 21 Because of the biocompatibility of the device, there is no need to remove the device in a second surgery, which can avoid potential injuries. 22…”

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

“…All clinical tests were negative in 12 patients, seven had one positive test, three had two positive tests, and one had three positive tests. The mean CS result at the follow-up was 93.44 ± 4.90 (range, 84-100), and the mean SST result was 10.78 ± 1.51 (range, [6][7][8][9][10][11][12]. There was no statistically significant association between the CS results and either shoulder tests or radiological findings.…”

“…Later, the classification was expanded by Rockwood and Green to types I to VI [4,[9][10][11]. It is widely accepted that type I-II injuries should be treated conservatively, and type IV-VI surgically [3][4][5][12][13][14][15]. The treatment of Rockwood type III injuries remains an object for debate: some studies advocate surgical treatment whilst others do not see a significant difference between surgical and conservative approaches, and highlight that each case should be treated individually [13,14,16].…”

Influence of disruption of the acromioclavicular and coracoclavicular ligaments on glenohumeral motion: a kinematic evaluation

“…Injuries to the acromioclavicular (AC) joint are often affect the coracoclavicular (CC) ligaments [1]. They account for up to 9% of all shoulder injuries and are second only to glenohumeral joint dislocations [2]. Changes to the integrity of the AC joint impact the shoulder’s function [3–5] since they alter both scapulothroacic and glenohumeral (GH) kinematics [1, 6, 7].…”