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

Tamaoki, Marcel Jun Sugawara; Lenza, Mário; Matsunaga, Fábio Teruo; Belloti, João Carlos; Matsumoto, Marcelo Hide; Faloppa, Flávio

doi:10.1002/14651858.cd007429.pub3

Cited by 58 publications

(73 citation statements)

References 70 publications

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“…Acromioclavicular dislocation (ACD) is one of the most common orthopaedic problems and accounts for 9% of all shoulder injuries 1,2 . High‐grade injuries (Rockwood IV and above) require surgery.…”

Section: Introductionmentioning

confidence: 99%

“…A variety of surgical techniques have been reported to reestablish the anatomical acromioclavicular (AC) joint alignment. However, there is still no gold standard surgical approach 1–6 .…”

Section: Introductionmentioning

confidence: 99%

“…Early surgical procedures applying Kirchner wires or Steinman pins are no longer used due to the case reports of pin migration and the limitation of relative motion between the scapula and clavicle 2–6 . The hook plate through the acromion requires a secondary operation for implant removal and increases the risk of AC ligament injury 7, 8 .…”

Section: Introductionmentioning

confidence: 99%

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Novel Double Endobutton Technique Combined with Three‐Dimensional Printing: A Biomechanical Study of Reconstruction in Acromioclavicular Joint Dislocation

Zhang

Jin³

et al. 2020

Orthopaedic Surgery

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Objective: To reconstruct the acromioclavicular (AC) joint using an adjusted closed-loop double Endobutton technique via a guiding locator that was applied using three-dimensional (3D) printing technology. At the same time, the reliability and safety of the novel double Endobutton (NDE) were tested by comparing the biomechanics of this technique with the TightRope (TR) approach. Methods: This retrospective study was conducted between January 2017 and January 2019. The Department of Anatomy at Southern Medical University obtained 18 fresh-frozen specimens (8 left and 10 right; 12 men and 6 women). First, the guiding locators were applied using 3D printing technology. After preparation of materials, specimens were divided into an NDE group, a TR group, and a normal group. In the NDE and TR groups, the navigation module was used to locate and establish the bone tunnels; after that, the NDE or TR was implanted. However, the Endobuttons were fixed while pressing the distal clavicle downwards and the length of the loop could be adjusted by changing the upper Endobutton in the NDE group while the suture button construct was tensioned and knotted after pressing down the distal clavicle in the TR. Finally, load testing in anterior-posterior (AP), superior-inferior (SI), and medial-lateral (ML) directions as well as load-to-failure testing in the SI direction were undertaken to verify whether the NDE or TR had better biomechanics. Results: In the load testing, the displacements of the NDE and TR groups in the AP, SI, and ML direction were significantly shorter than those of the normal group (P < 0.05). In the load-to-failure testing, the ultimate load of the NDE and TR groups had significantly higher increases than the normal group (722.16 ± 92.04 vs 564.63 ± 63.05, P < 0.05; 680.20 ± 110.29 vs 564.63 ± 63.05, P < 0.05). However, there was no statistically significant difference between the two techniques for these two tests (P > 0.05). In the NDE group, four of six failures were a result of tunnel fractures of the coracoid, while two of six were due to suture breakage. In the TR, three failures were due to coracoid tunnel fractures, one was a result of a clavicle tunnel fracture, and the rest were due to suture breakage. In the

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Novel Double Endobutton Technique Combined with Three‐Dimensional Printing: A Biomechanical Study of Reconstruction in Acromioclavicular Joint Dislocation

Zhang

Jin³

et al. 2020

Orthopaedic Surgery

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“…However, there has been considerable discussion comparing the conservative method of treatment with the surgical one regarding type-III injuries, with several studies conducted on the issue but with no consensus on the ideal choice. [4][5][6][7][8][9] There are more than 200 surgical techniques, 10 and most of those that aim at joint fixation and reconstruction of the coracoclavicular ligament involve the use of metal implants, including Kirschner wires, Steinmann pins, hook plate fixation, and Bosworth screws. One of the most employed and widespread techniques for surgical treatment is the modified Weaver-Dunn procedure, which involves the transfer of the coracoacromial ligament and its insertion in the acromion to the distal third of the clavicle with the aid of ties.…”

Section: Introductionmentioning

confidence: 99%

Functional results of surgical treatment for acromioclavicular joint dislocation using the modified weaver-dunn surgical technique

Neto¹,

Souza²,

Queiroz³

et al. 2020

MOJOR

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“… 1 , 2 However, decision-making regarding nonoperative versus operative management or the type of operative technique is complicated, given the absence of high-quality comparative studies. 3 …”

mentioning

confidence: 99%

Arthroscopically Assisted Acromioclavicular Joint Reconstruction Using the Infinity-Lock Button System With Allograft Augmentation

MacLean

Frank²,

Trenhaile

2020

Arthroscopy Techniques

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Acromioclavicular (AC) joint injuries are extremely common in the athletic population. Although most low-grade injuries can be managed nonoperatively, high-grade injuries often require reconstruction of the AC joint. Various reconstructive options have been described with varying risks and benefits to each. Implant or graft failure with loss of reduction as well as clavicle and coracoid fracture are a few of the more common complications following AC joint reconstruction surgery. Currently, no gold standard exists. This technical paper describes an arthroscopically assisted AC joint reconstruction technique using the Infinity-Lock Button System with hamstring allograft augmentation. This technique provides an anatomic, minimally invasive, low-profile reconstruction that may minimize risk of clavicle and coracoid fracture. It also provides augmented stabilization across the AC joint, which may also help resist naturally occurring horizontal and rotational displacing forces.

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

Cited by 58 publications

References 70 publications

Novel Double Endobutton Technique Combined with Three‐Dimensional Printing: A Biomechanical Study of Reconstruction in Acromioclavicular Joint Dislocation

Novel Double Endobutton Technique Combined with Three‐Dimensional Printing: A Biomechanical Study of Reconstruction in Acromioclavicular Joint Dislocation

Functional results of surgical treatment for acromioclavicular joint dislocation using the modified weaver-dunn surgical technique

Arthroscopically Assisted Acromioclavicular Joint Reconstruction Using the Infinity-Lock Button System With Allograft Augmentation

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