Surgical management of chronic high-grade acromioclavicular joint dislocations: a systematic review

Borbas, Paul; Churchill, James; Ek, Eugene T.

doi:10.1016/j.jse.2019.03.005

Cited by 61 publications

(71 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…53 Also, the reported complication rate was relatively low (15.5%) when considering the highest rate (33.8%) of previous AC joint reconstructions in the tendon graft group. 53 Current literature focusses on "anatomic" reconstruction of the CC ligaments, to best restore the native CC and AC ligaments. 82,87,89,91 However, it is hard to determine which AC joint reconstruction is truly anatomical.…”

Section: Reconstruction With Allo-and Autograftsmentioning

confidence: 80%

“…allograft or autograft) fixation techniques. 53 Furthermore, ligament and tendon transfers resulted in the highest overall complication rate (17.3%) with infections being the most common complication (7.4%). 53…”

Section: Ligament and Tendon Transfersmentioning

confidence: 99%

“…35,38,39,52 While acute treatment of AC joint dislocations aims to approximate the ends of the AC and CC ligaments in order to achieve healing, the biological capabilities are compromised in chronic cases. 35,53,54 Therefore, mechanical stabilization of the dislocated joint alone without the use of biological augmentation may be insufficient. The next paragraphs aim to provide an overview of historical and current treatment concepts of chronic AC joint instability.…”

Section: Ac-reconstruction In Chronic Casesmentioning

confidence: 99%

“…Although, allografts and autografts such as palmaris longus, 60,82 flexor carpi radialis, 82 peroneus longus, 83 and tibialis anterior tendons 84 have been utilized for the treatment of AC joint dislocations, hamstring tendons are most commonly used. 53,64,77,[84][85][86][87] Tendon grafts are used in both acute and chronic AC joint dislocations, however, they are most beneficial in chronic AC joint injuries, since in order to facilitate healing, biological augmentation is needed. 88 Free tendon grafts have been shown to provide superior biomechanical strength compared to the Weaver-Dunn procedure 65,82,87,89 and similar biomechanical strength to suspensory button devices.…”

Section: Reconstruction With Allo-and Autograftsmentioning

confidence: 99%

See 3 more Smart Citations

<p>Optimal Management of Acromioclavicular Dislocation: Current Perspectives</p>

Nolte¹,

Lacheta²,

Dekker³

et al. 2020

ORR

View full text Add to dashboard Cite

Injuries to the acromioclavicular (AC) joint are common and mostly involve younger, male individuals. Whereas the majority of AC joint dislocations can be treated nonoperatively with a trial of immobilization, pain medication, cryotherapy, and physiotherapy, there are patients that do not respond well to conservative management and may require surgical treatment. Identifying and treating these patients according to the type and chronicity of AC joint dislocation is paramount. To date, a myriad of surgical techniques have been proposed to address unstable AC joint dislocations and are indicative of the uncertainty that exists in optimal management of these injuries. Historically research has focused on the restoration of the coracoclavicular ligament complex. However, recently the importance of the acromioclavicular capsule and ligaments has been emphasized. This review aims to provide the reader with an overview of current treatment strategies and research, as well as future perspectives.

show abstract

Section: Reconstruction With Allo-and Autograftsmentioning

confidence: 80%

Section: Ligament and Tendon Transfersmentioning

confidence: 99%

Section: Ac-reconstruction In Chronic Casesmentioning

confidence: 99%

Section: Reconstruction With Allo-and Autograftsmentioning

confidence: 99%

See 2 more Smart Citations

<p>Optimal Management of Acromioclavicular Dislocation: Current Perspectives</p>

Nolte¹,

Lacheta²,

Dekker³

et al. 2020

ORR

View full text Add to dashboard Cite

show abstract

“…Recurrent AC joint instability remains a common challenge in the orthopaedic literature. 1,7,12,20,36 The definition of failure includes loss of reduction, leading to chronic scapular or glenohumeral joint dysfunction or pain, (sub)luxation with persistent vertical or horizontal instability of the AC joint, infections, hardware failure, and fractures. 1,28,30,[46][47][48] To date, more than 150 different stabilization techniques have been described, with complication rates being highly dependent on the type of repair.…”

Section: Discussionmentioning

confidence: 99%

Minimum 10-Year Outcomes After Revision Anatomic Coracoclavicular Ligament Reconstruction for Acromioclavicular Joint Instability

Berthold

Muench

Beitzel

et al. 2020

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

Background: Revision surgery in cases of previously failed primary acromioclavicular (AC) joint stabilization remains challenging mainly because of anatomic alterations or technical difficulties. However, anatomic coracoclavicular ligament reconstruction (ACCR) has been shown to achieve encouraging biomechanical, clinical, and radiographic short-term to midterm results. Purpose: To evaluate the clinical and radiographic long-term outcomes of patients undergoing revision ACCR after failed operative treatment for type III through V AC joint injuries with a minimum 10-year follow-up. Study Design: Case series; Level of evidence, 4. Methods: A retrospective chart review was performed on prospectively collected data within an institutional shoulder registry. Patients who underwent revision ACCR for type III through V AC joint injuries between January 2003 and December 2009 were analyzed. Clinical outcome measures included the American Shoulder and Elbow Surgeons (ASES) score, Simple Shoulder Test (SST), and Single Assessment Numeric Evaluation (SANE). The coracoclavicular distance (CCD) was measured for radiographic analysis immediately postoperatively and at last postoperative follow-up. Results: A total of 8 patients with a mean age at the time of surgery of 44.6 ± 10.6 years and a mean follow-up of 135.0 ± 17.4 months (range, 120-167 months) were eligible for inclusion in the study. The time from initial AC joint stabilization until revision surgery was 10.2 ± 12.4 months (range, 0.5-36 months); 62.5% of the patients had undergone more than 2 previous AC joint surgical procedures. The ASES score improved from 43.9 ± 22.4 preoperatively to 80.6 ± 28.8 postoperatively ( P = .012), the SST score improved from 4.4 ± 3.6 preoperatively to 11.0 ± 2.2 postoperatively ( P = .017), and the SANE score improved from 31.4 ± 27.3 preoperatively to 86.9 ± 24.1 postoperatively ( P = .018) at final follow-up. There was no significant difference in the CCD ( P = .08) between the first (7.6 ± 3.0 mm) and final (10.6 ± 2.8 mm) radiographic follow-up (mean, 50.5 ± 32.7 months [range, 18-98 months]). Conclusion: Patients undergoing revision ACCR after failed operative treatment for type III through V AC joint injuries maintained significant improvement in clinical outcomes at a minimum 10-year follow-up.

show abstract

Surgical versus conservative interventions for treating acromioclavicular dislocation of the shoulder in adults

Tamaoki

Lenza

Matsunaga

et al. 2019

Cochrane Database of Systematic Reviews

View full text Add to dashboard Cite

Surgical management of chronic high-grade acromioclavicular joint dislocations: a systematic review

Cited by 61 publications

References 36 publications

<p>Optimal Management of Acromioclavicular Dislocation: Current Perspectives</p>

<p>Optimal Management of Acromioclavicular Dislocation: Current Perspectives</p>

Minimum 10-Year Outcomes After Revision Anatomic Coracoclavicular Ligament Reconstruction for Acromioclavicular Joint Instability

Surgical versus conservative interventions for treating acromioclavicular dislocation of the shoulder in adults

Contact Info

Product

Resources

About