Skip to main content
Top
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 5/2015

01-05-2015 | Shoulder

Arthroscopic treatment of acute acromioclavicular joint dislocation by coracoclavicular ligament augmentation

Authors: Xudong Liu, Xiaoqiao Huangfu, Jinzhong Zhao

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 5/2015

Login to get access

Abstract

Purpose

Coracoclavicular (CC) ligament augmentation has been a method to treat acromioclavicular (AC) joint dislocation in recent years. The purpose of this paper is to describe our arthroscopic CC ligament augmentation technique in treating type III and V acute AC joint dislocations and to report the early clinical and radiological results.

Methods

From 2010 to 2011, twelve patients suffering from acute type III or V AC joint dislocations were arthroscopically treated in our department, by CC ligament augmentation after AC joint reduction. The post-operative outcomes were assessed through physical examination, radiographic examination and the Constant–Murley Shoulder Score.

Results

All patients post-operatively experienced anatomical reduction in their AC joint dislocation. No intraoperative complications occurred. At a mean follow-up at 24 months (ranging from 18 to 32 months), the mean Constant–Murley Shoulder Score significantly improved from 24.3 pre-operatively to 91.1 post-operatively. No neurovascular complications or secondary degenerative changes of the AC joint were detected in any of the patients. In one case, a second dislocation occurred 1 month post-operation because the patient had had another traumatic injury. This patient accepted a revision operation, but his AC joint eventually fixated into a subluxated position after his second injury.

Conclusion

Based on the resultant successful repair in all cases, the arthroscopic CC ligament augmentation method has thus far proven to be a safe and reliable technique for treatment of acute type III or V AC joint dislocation.

Clinical relevance

The arthroscopic CC ligament augmentation with a flip button/polyethylene belt repair is an efficient method to treat acute type III and V AC joint dislocations which should be popularized.

Level of evidence

IV.
Literature
1.
go back to reference Baumgarten KM, Altcheck DW, Cordasco FA (2006) Arthroscopically assisted acromioclavicular joint reconstruction. Arthroscopy 22(2):228 e1-228 e6 Baumgarten KM, Altcheck DW, Cordasco FA (2006) Arthroscopically assisted acromioclavicular joint reconstruction. Arthroscopy 22(2):228 e1-228 e6
2.
go back to reference Blatter G, Meier G (1990) Augmentation of the coraco-clavicular ligament suture. Comparison between wire cerclage, vicryl tape and PDS cord. Unfallchirurg 93(12):578–583PubMed Blatter G, Meier G (1990) Augmentation of the coraco-clavicular ligament suture. Comparison between wire cerclage, vicryl tape and PDS cord. Unfallchirurg 93(12):578–583PubMed
3.
go back to reference Boileau P, Old J, Gastaud O, Brassart N, Roussanne Y (2010) All-arthroscopic Weaver-Dunn-Chuinard procedure with double-button fixation for chronic acromioclavicular joint dislocation. Arthroscopy 26(2):149–160CrossRefPubMed Boileau P, Old J, Gastaud O, Brassart N, Roussanne Y (2010) All-arthroscopic Weaver-Dunn-Chuinard procedure with double-button fixation for chronic acromioclavicular joint dislocation. Arthroscopy 26(2):149–160CrossRefPubMed
4.
go back to reference Costic RS, Labriola JE, Rodosky MW, Debski RE (2004) Biomechanical rationale for development of anatomical reconstructions of CC ligaments after complete acromioclavicular joint dislocations. Am J Sports Med 32(8):1929–1936CrossRefPubMed Costic RS, Labriola JE, Rodosky MW, Debski RE (2004) Biomechanical rationale for development of anatomical reconstructions of CC ligaments after complete acromioclavicular joint dislocations. Am J Sports Med 32(8):1929–1936CrossRefPubMed
5.
go back to reference Di Francesco A, Zoccali C, Colafarina O, Pizzoferrato R, Flamini S (2012) The use of hook plate in type III and V acromio-clavicular Rockwood dislocations: clinical and radiological midterm results and MRI evaluation in 42 patients. Injury 43(2):147–152CrossRefPubMed Di Francesco A, Zoccali C, Colafarina O, Pizzoferrato R, Flamini S (2012) The use of hook plate in type III and V acromio-clavicular Rockwood dislocations: clinical and radiological midterm results and MRI evaluation in 42 patients. Injury 43(2):147–152CrossRefPubMed
6.
go back to reference Fraschini G, Ciampi P, Scotti C, Ballis R, Peretti GM (2010) Surgical treatment of chronic acromioclavicular dislocation: comparison between two surgical procedures for anatomic reconstruction. Injury 41(11):1103–1106CrossRefPubMed Fraschini G, Ciampi P, Scotti C, Ballis R, Peretti GM (2010) Surgical treatment of chronic acromioclavicular dislocation: comparison between two surgical procedures for anatomic reconstruction. Injury 41(11):1103–1106CrossRefPubMed
7.
go back to reference Fu FH, Shen W, Starman JS, Okeke N, Irrgang JJ (2008) Primary anatomic double-bundle anterior cruciate ligament reconstruction. Am J Sports Med 36(7):1268–1274CrossRef Fu FH, Shen W, Starman JS, Okeke N, Irrgang JJ (2008) Primary anatomic double-bundle anterior cruciate ligament reconstruction. Am J Sports Med 36(7):1268–1274CrossRef
8.
go back to reference Grutter PW, Petersen SA (2005) Anatomical acromioclavicular ligament reconstruction: a biomechanical comparison of reconstructive techniques of the acromioclavicular joint. Am J Sports Med 33(11):1723–1728CrossRefPubMed Grutter PW, Petersen SA (2005) Anatomical acromioclavicular ligament reconstruction: a biomechanical comparison of reconstructive techniques of the acromioclavicular joint. Am J Sports Med 33(11):1723–1728CrossRefPubMed
9.
go back to reference Harris RI, Wallace AL, Harper GD, Goldberg JA, Sonnabend DH, Walsh WR (2000) Structural properties of the intact and the reconstructed coracoclavicular ligament complex. Am J Sports Med 28(1):103–108PubMed Harris RI, Wallace AL, Harper GD, Goldberg JA, Sonnabend DH, Walsh WR (2000) Structural properties of the intact and the reconstructed coracoclavicular ligament complex. Am J Sports Med 28(1):103–108PubMed
10.
go back to reference Hosseini H, Friedmann S, Tröger M, Lobenhoffer P, Agneskirchner JD (2009) Arthroscopic reconstruction of chronic AC joint dislocations by transposition of the coracoacromial ligament augmented by the Tight Rope device: a technical note. Knee Surg Sports Traumatol Arthrosc 17(1):92–97CrossRefPubMed Hosseini H, Friedmann S, Tröger M, Lobenhoffer P, Agneskirchner JD (2009) Arthroscopic reconstruction of chronic AC joint dislocations by transposition of the coracoacromial ligament augmented by the Tight Rope device: a technical note. Knee Surg Sports Traumatol Arthrosc 17(1):92–97CrossRefPubMed
11.
go back to reference Huang TW, Hsieh PH, Huang KC, Huang KC (2009) Suspension suture augmentation for repair of coracoclavicular ligament disruptions. Clin Orthop Relat Res 467(8):2142–2148CrossRefPubMedCentralPubMed Huang TW, Hsieh PH, Huang KC, Huang KC (2009) Suspension suture augmentation for repair of coracoclavicular ligament disruptions. Clin Orthop Relat Res 467(8):2142–2148CrossRefPubMedCentralPubMed
12.
go back to reference Jerosch J, Filler T, Peuker E, Greig M, Siewering U (1999) Which stabilization technique corrects anatomy best in patients with AC-separation? An experimental study. Knee Surg Sports Traumatol Arthrosc 7(6):365–372CrossRefPubMed Jerosch J, Filler T, Peuker E, Greig M, Siewering U (1999) Which stabilization technique corrects anatomy best in patients with AC-separation? An experimental study. Knee Surg Sports Traumatol Arthrosc 7(6):365–372CrossRefPubMed
13.
go back to reference Kanamori A, Woo SL, Ma CB, Zeminski J, Rudy TW, Li G, Livesay GA (2000) The forces in the anterior cruciate ligament and knee kinematics during a simulated pivot shift test: a human cadaveric study using robotic technology. Arthroscopy 16(6):633–639CrossRefPubMed Kanamori A, Woo SL, Ma CB, Zeminski J, Rudy TW, Li G, Livesay GA (2000) The forces in the anterior cruciate ligament and knee kinematics during a simulated pivot shift test: a human cadaveric study using robotic technology. Arthroscopy 16(6):633–639CrossRefPubMed
14.
go back to reference Kim SH, Lee YH, Shin SH, Lee YH, Baek GH (2012) Outcome of conjoined tendon and coracoacromial ligament transfer for the treatment of chronic type V acromioclavicular joint separation. Injury 43(2):213–218CrossRefPubMed Kim SH, Lee YH, Shin SH, Lee YH, Baek GH (2012) Outcome of conjoined tendon and coracoacromial ligament transfer for the treatment of chronic type V acromioclavicular joint separation. Injury 43(2):213–218CrossRefPubMed
15.
go back to reference Lädermann A, Grosclaude M, Lübbeke A, Christofilopoulos P, Stern R, Rod T, Hoffmeyer P (2011) Acromioclavicular and coracoclavicular cerclage reconstruction for acute acromioclavicular joint dislocations. J Shoulder Elbow Surg 20(3):401–408CrossRefPubMed Lädermann A, Grosclaude M, Lübbeke A, Christofilopoulos P, Stern R, Rod T, Hoffmeyer P (2011) Acromioclavicular and coracoclavicular cerclage reconstruction for acute acromioclavicular joint dislocations. J Shoulder Elbow Surg 20(3):401–408CrossRefPubMed
16.
go back to reference Leidel BA, Braunstein V, Kirchhoff C, Pilotto S, Mutschler W, Biberthaler P (2009) Consistency of long-term outcome of acute Rockwood grade III acromioclavicular joint separations after K-wire transfixation. J Trauma 66(6):1666–1671CrossRefPubMed Leidel BA, Braunstein V, Kirchhoff C, Pilotto S, Mutschler W, Biberthaler P (2009) Consistency of long-term outcome of acute Rockwood grade III acromioclavicular joint separations after K-wire transfixation. J Trauma 66(6):1666–1671CrossRefPubMed
17.
go back to reference Lu N, Zhu L, Ye T, Chen A, Jiang X, Zhang Z, Zhu Q, Guo Q, Yang D (2013) Evaluation of the coracoclavicular reconstruction using LARS artificial ligament in acute acromioclavicular joint dislocation. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-013-2582-0 Lu N, Zhu L, Ye T, Chen A, Jiang X, Zhang Z, Zhu Q, Guo Q, Yang D (2013) Evaluation of the coracoclavicular reconstruction using LARS artificial ligament in acute acromioclavicular joint dislocation. Knee Surg Sports Traumatol Arthrosc. doi:10.​1007/​s00167-013-2582-0
18.
go back to reference Martetschläger F, Buchholz A, Sandmann G, Siebenlist S, Döbele S, Hapfelmeier A, Stöckle U, Millett PJ, Elser F, Lenich A (2013) Acromioclavicular and coracoclavicular PDS augmentation for complete AC joint dislocation showed insufficient properties in a cadaver model. Knee Surg Sports Traumatol Arthrosc 21(2):438–444CrossRefPubMed Martetschläger F, Buchholz A, Sandmann G, Siebenlist S, Döbele S, Hapfelmeier A, Stöckle U, Millett PJ, Elser F, Lenich A (2013) Acromioclavicular and coracoclavicular PDS augmentation for complete AC joint dislocation showed insufficient properties in a cadaver model. Knee Surg Sports Traumatol Arthrosc 21(2):438–444CrossRefPubMed
19.
go back to reference Millett PJ, Braun S, Gobezie R, Pacheco IH (2009) Acromioclavicular joint reconstruction with coracoacromial ligament transfer using the docking technique. BMC Musculoskelet Disord 10:6CrossRefPubMedCentralPubMed Millett PJ, Braun S, Gobezie R, Pacheco IH (2009) Acromioclavicular joint reconstruction with coracoacromial ligament transfer using the docking technique. BMC Musculoskelet Disord 10:6CrossRefPubMedCentralPubMed
20.
go back to reference Rockwood CA, Williams GR, Young DC (2004) Disorders of the acromioclavicular joint. In: Rockwood CA, Matsen FA (eds) The Shoulder, 3rd edn. WB Saunders, Philadelphia, Pa, USA, pp 521–595 Rockwood CA, Williams GR, Young DC (2004) Disorders of the acromioclavicular joint. In: Rockwood CA, Matsen FA (eds) The Shoulder, 3rd edn. WB Saunders, Philadelphia, Pa, USA, pp 521–595
21.
go back to reference Shin SJ, Yun YH, Yoo JD (2009) Coracoclavicular ligament reconstruction for acromioclavicular dislocation using 2 suture anchors and coracoacromial ligament transfer. Am J Sports Med 37(2):346–351CrossRefPubMed Shin SJ, Yun YH, Yoo JD (2009) Coracoclavicular ligament reconstruction for acromioclavicular dislocation using 2 suture anchors and coracoacromial ligament transfer. Am J Sports Med 37(2):346–351CrossRefPubMed
22.
go back to reference Vahey JW, Draganich LF (1991) Tensions in the anterior and posterior cruciate ligaments of the knee during passive loading: predicting ligament loads from in situ measurements. J Orthop Res 9(4):529–538CrossRefPubMed Vahey JW, Draganich LF (1991) Tensions in the anterior and posterior cruciate ligaments of the knee during passive loading: predicting ligament loads from in situ measurements. J Orthop Res 9(4):529–538CrossRefPubMed
23.
go back to reference Wellmann M, Zantop T, Petersen W (2007) Minimally invasive coracoclavicular ligament augmentation with a flip button/polydioxanone repair for treatment of total acromioclavicular joint dislocation. Arthroscopy 23(10):1132 e1–e5 Wellmann M, Zantop T, Petersen W (2007) Minimally invasive coracoclavicular ligament augmentation with a flip button/polydioxanone repair for treatment of total acromioclavicular joint dislocation. Arthroscopy 23(10):1132 e1–e5
24.
go back to reference Wellmann M, Zantop T, Weimann A, Raschke MJ, Petersen W (2007) Biomechanical evaluation of minimally invasive repairs for complete acromioclavicular joint dislocation. Am J Sports Med 35(6):955–961CrossRefPubMed Wellmann M, Zantop T, Weimann A, Raschke MJ, Petersen W (2007) Biomechanical evaluation of minimally invasive repairs for complete acromioclavicular joint dislocation. Am J Sports Med 35(6):955–961CrossRefPubMed
25.
go back to reference Yasuda K, Kondo E, Ichiyama H, Kitamura N, Tanabe Y, Tohyama H, Minami A (2004) Anatomic reconstruction of the anteromedial and posterolateral bundles of the anterior cruciate ligament using hamstring tendon grafts. Arthroscopy 20(10):1015–1025CrossRefPubMed Yasuda K, Kondo E, Ichiyama H, Kitamura N, Tanabe Y, Tohyama H, Minami A (2004) Anatomic reconstruction of the anteromedial and posterolateral bundles of the anterior cruciate ligament using hamstring tendon grafts. Arthroscopy 20(10):1015–1025CrossRefPubMed
26.
go back to reference Yoo YS, Seo YJ, Noh KC, Patro BP, Kim DY (2011) Arthroscopically assisted anatomical coracoclavicular ligament reconstruction using tendon graft. Int Orthop 35(7):1025–1030CrossRefPubMedCentralPubMed Yoo YS, Seo YJ, Noh KC, Patro BP, Kim DY (2011) Arthroscopically assisted anatomical coracoclavicular ligament reconstruction using tendon graft. Int Orthop 35(7):1025–1030CrossRefPubMedCentralPubMed
Metadata
Title
Arthroscopic treatment of acute acromioclavicular joint dislocation by coracoclavicular ligament augmentation
Authors
Xudong Liu
Xiaoqiao Huangfu
Jinzhong Zhao
Publication date
01-05-2015
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 5/2015
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-013-2800-9

Other articles of this Issue 5/2015

Knee Surgery, Sports Traumatology, Arthroscopy 5/2015 Go to the issue