The Infinity-Lock System for Chronic Grade III AC Joint Dislocation: A Novel Technique, Rehabilitation Protocol and Short Term Results

Abstract

Background: the choice of treatment of chronic grade III acromioclavicular (AC) joint dislocation is controversial. Several surgical techniques have been described in the literature, responding differently to nonoperative treatment. The aim of this study is to describe a modified technique of stabilizing an AC joint dislocation with the new Infinity-Lock Button System, in order to demonstrate that it is effective in optimizing outcomes and decreasing complications. Methods: this is a retrospective study of 15 patients who underwent surgical stabilization of the AC joint dislocation between 2018 and 2019, through modified surgical technique using the Infinity-Lock Button System. Active range of motion (ROM), Specific Acromio Clavicular Score (SACS) and Constant Score (CS) were evaluated preoperatively and postoperatively at last 18 months follow up. Patients rated their outcomes as very good, good, satisfactory, or unsatisfactory. Results: a total of twelve patients rated their outcome as very good and three as good; no patients were dissatisfied with surgery. The mean Constant Score increased from 38 points preoperatively to 95 postoperatively, the average SACS score decreased from 52 points preoperatively to 10 postoperatively, both significantly. No complications were detected. Conclusion: the described technique is effective for treatment of chronic grade III AC joint dislocation, resulting in elevated satisfaction ratings and predictable outcomes. Nevertheless, further longer term follow-up studies are required.

Does Weaver–Dunn procedure have a role in chronic acromioclavicular dislocations? A meta-analysis

“…In terms of range of motion, the CCR group showed better post-operative abduction (post-ABD), flexion (post-FLEX), and external rotation (post-ER) of the index shoulder than the WD group with a statistical difference (post-ABD, 176.9 versus 172.4 degree, 95% CI 1.90-6.64, p = 0.0004; post-FLEX, 177.9 versus 171.8 degree, 95% CI 2.91-9.36, p = 0.0002; post-ER, 64.4 versus 56.5 degree, 95% CI 3.31-12.26, p = 0.0007) (Figs. 6,7,8).…”

“…There are numerous variations in surgical techniques when treating symptomatic chronic acromioclavicular (AC) joint dislocations after failure of conservative treatment, each with their own respective advantages and disadvantages. The surgical techniques include AC and coracoclavicular reconstruction (CCR), with either biological or artificial grafts [1][2][3][4]), ligament transfers, such as coracoaromial ligament transfers, the Weaver-Dunn (WD) procedure [2,5,6], conjoined tendon transfers [7]), and various fixation techniques [8][9][10][11][12].…”

Kinematic and Radiographic Evaluation of Acromioclavicular Reconstruction with a Synthetic Ligament

“…Multiple operative treatment options exist for acute and chronic AC joint Instabilities, including nonbiological fixation between coracoid and clavicle (e.g., suture loops and synthetic ligaments), biological reconstruction of the CC ligaments (e.g., allograft or autograft tendon reconstruction), ligament and/or tendon transfer (e.g., Weaver–Dunn and Dewar procedures), and fixation with Kirschner wires (e.g., Phemister technique), a hook plate, or other extra-articular techniques [ 15 ]. The LockDown device (LockDown Medical, Redditch, Worcestershire, UK) is a synthetic ligament, consisting of a double braided polyethylene terephthalate ( Figure 1 ).…”

New Trends in Shoulder Surgery from Biomechanics to the Operating Room

“…Three papers published by the group of Romano et al [ 2 , 3 , 4 ] are focused on both shoulder arthroscopy and arthroplasty.…”

“…The first one [ 4 ] proves that the Infinity-lock button system is effective for the treatment of chronic grade III AC joint dislocation, resulting in elevated satisfaction ratings and predictable outcomes.…”