Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 7/2021

01-07-2021 | Painful Arc | SHOULDER

Anatomic reconstruction of the coracoclavicular and acromioclavicular ligaments with semitendinosus tendon graft for the treatment of chronic acromioclavicular joint dislocation provides good clinical and radiological results

Authors: Maristella F. Saccomanno, Giacomo Marchi, Fabrizio Mocini, Valeria Vismara, Vincenzo Campana, Andrea G. Salvi, Alessandra Scaini, Giuseppe Milano

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 7/2021

Login to get access

Abstract

Purpose

To evaluate clinical and radiographic outcomes of anatomical reconstruction of the coracoclavicular and acromioclavicular ligaments with single-strand semitendinosus tendon graft for the treatment of chronic acromioclavicular joint dislocation.

Methods

Patients affected by chronic type III–V acromioclavicular joint dislocations were included. Exclusion criteria were: age under 18 years, concomitant rotator cuff tears, previous surgery to the same shoulder, degenerative changes of the glenohumeral joint, infections, neurologic diseases, patients with a previous history of ligament reconstruction procedures that had required harvesting of the semitendinosus tendon from the ipsilateral or contralateral knee. All patients underwent the same surgical technique and rehabilitation. Primary outcome was the normalized Constant score. Secondary outcomes were: DASH score, radiographic evaluation of loss of reduction and acromioclavicular joint osteoarthritis.

Results

Thirty patients with a mean age of 28.9 ± 8.3 years were included. Mean time to surgery was 12.8 ± 10 months. Mean follow-up was 28.1 ± 2.4 months (range: 24–32). Comparison between pre- and postoperative functional scores showed significant clinical improvement (p < 0.001). Time to surgery was independently associated with a poorer Constant score (p < 0.0001). On radiographs, 4 patients (13.3%) showed asymptomatic partial loss of reduction.

Conclusion

Anatomic reconstruction of coracoclavicular and acromioclavicular ligaments using a semitendinosus tendon graft for the treatment of chronic acromioclavicular joint dislocation provided good clinical and radiological results at minimum 2-year follow-up.

Level of evidence

Level III.
Literature
1.
Bagg SD, Forrest WJ (1988) A biomechanical analysis of scapular rotation during arm abduction in the scapular plane. Am J Phys Med Rehabil 67:238–245PubMed
2.
Barth J, Duparc F, Baverel L, Bahurel J, Toussaint B, Bertiaux S, Clavert P, Gastaud O, Brassart N, Beaudouin E, De Mourgues P, Berne D, Duport M, Najihi N, Boyer P, Faivre B, Meyer A, Nourissat G, Poulain S, Bruchou F, Ménard JF, d’Arthroscopie SF (2015) Prognostic factors to succeed in surgical treatment of chronic acromioclavicular dislocations. OrthopTraumatolSurg Res 101:S305–311
3.
Borbas P, Churchill J, Ek ET (2019) Surgical management of chronic high-grade acromioclavicular joint dislocations: a systematic review. J Shoulder Elbow Surg 28:2031–2038PubMed
4.
Carbone S, Postacchini R, Gumina S (2015) Scapular dyskinesis and SICK syndrome in patients with a chronic type III acromioclavicular dislocation. Results of rehabilitation. Knee Surg Sports TraumatolArthrosc 23:1473–1480
5.
Carofino BC, Mazzocca AD (2010) The anatomic coracoclavicular ligament reconstruction: surgical technique and indications. J Shoulder Elbow Surg 19:37–46PubMed
6.
Charles ER, Kumar V, Blacknall J, Edwards K, Geoghegan JM, Manning PA, Wallace WA (2017) A validation of the Nottingham Clavicle Score: a clavicle, acromioclavicular joint and sternoclavicular joint-specific patient-reported outcome measure. J Shoulder Elbow Surg 26:1732–1739PubMed
7.
Clavert P, Meyer A, Boyer P, Gastaud O, Barth J, Duparc F (2015) Complication rates and types of failure after arthroscopic acute acromioclavicular dislocation fixation. Prospective multicenter study of 116 cases. OrthopTraumatolSurg Res 101:S313–316
8.
Cook JB, Krul KP (2018) Challenges in Treating Acromioclavicular Separations: Current Concepts. J Am AcadOrthopSurg 26:669–677
9.
Cook JB, Shaha JS, Rowles DJ, Bottoni CR, Shaha SH, Tokish JM (2012) Early failures with single claviculartransosseouscoracoclavicular ligament reconstruction. J Shoulder Elbow Surg 21:1746–1752PubMed
10.
Cvetanovich GL, Gowd AK, Liu JN, Nwachukwu BU, Cabarcas BC, Cole BJ, Forsythe B, Romeo AA, Verma NN (2019) Establishing clinically significant outcome after arthroscopic rotator cuff repair. J Shoulder Elbow Surg 28:939–948PubMed
11.
Dabija DI, Jain NB (2019) Minimal clinically important difference of shoulder outcome measures and diagnoses: a systematic review. Am J Phys Med Rehabil 98:671–676PubMedPubMedCentral
12.
Deans CF, Gentile JM, Tao MA (2019) Acromioclavicular joint injuries in overhead athletes: a concise review of injury mechanisms, treatment options, and outcomes. Curr Rev Musculoskelet Med 12:80–86PubMedPubMedCentral
13.
Ernberg LA, Potter HG (2003) Radiographic evaluation of the acromioclavicular and sternoclavicular joints. Clin Sports Med 22:255–275PubMed
14.
Faul F, Erdfelder E, Lang A-G, Buchner A (2007) G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 39:175–191PubMed
15.
Frank RM, Cotter EJ, Leroux TS, Romeo AA (2019) Acromioclavicular joint injuries: evidence-based treatment. J Am AcadOrthopSurg 27:e775–e788
16.
Grassbaugh JA, Cole C, Wohlrab K, Eichinger J (2013) Surgical technique affects outcomes in acromioclavicular reconstruction. J SurgOrthopAdv 22:71–76
17.
Gumina S, Carbone S, Postacchini F (2009) Scapular dyskinesis and SICK scapula syndrome in patients with chronic type III acromioclavicular dislocation. Arthroscopy 25:40–45PubMed
18.
Hann C, Kraus N, Minkus M, Maziak N, Scheibel M (2018) Combined arthroscopically assisted coraco- and acromioclavicular stabilization of acute high-grade acromioclavicular joint separations. Knee Surg Sports TraumatolArthrosc 26:212–220
19.
Hippensteel KJ, Brophy R, Smith M, Wright R (2018) Surgical volume and postoperative complications of acromioclavicular joint separations: analysis of the ABOS Part II examination. Am J Sports Med 46:3174–3181PubMed
20.
Inoue D, Furuhata R, Kaneda K, Ritsuno Y, Kono A, Kiyota Y, Morioka H, Arino H (2019) Clavicle fracture at the suture hole after acromioclavicular joint reconstruction using a suture-button: a case report. BMC MusculoskeletDisord 20:333
21.
Kibler WB, Sciascia AD, Morris BJ, Dome DC (2017) Treatment of symptomatic acromioclavicular joint instability by a docking technique: clinical indications, surgical technique, and outcomes. Arthroscopy 33:696–708.e2PubMed
22.
Kraus N, Hann C, Minkus M, Maziak N, Scheibel M (2019) Primary versus revision arthroscopically-assisted acromio- and coracoclavicular stabilization of chronic AC-joint instability. Arch Orthop Trauma Surg 139:1101–1109PubMed
23.
Kukkonen J, Kauko T, Vahlberg T, Joukainen A, Aärimaa V (2013) Investigating minimal clinically important difference for Constant score in patients undergoing rotator cuff surgery. J Shoulder Elbow Surg 22:1650–1655PubMed
24.
Lee SK, Song DG, Choy WS (2015) Anatomical double-bundle coracoclavicular reconstruction in chronic acromioclavicular dislocation. Orthopedics 38:e655–662PubMed
25.
Longo UG, Ciuffreda M, Rizzello G, Mannering N, Maffulli N, Denaro V (2017) Surgical versus conservative management of Type III acromioclavicular dislocation: a systematic review. Br Med Bull 122:31–49PubMed
26.
Lopiz Y, Checa P, García-Fernández C, Valle J, Vega ML, Marco F (2019) Complications with the clavicle hook plate after fixation of Neer type II clavicle fractures. IntOrthop 43:1701–1708
27.
Mazzocca AD, Arciero RA, Bicos J (2007) Evaluation and treatment of acromioclavicular joint injuries. Am J Sports Med 35:316–329PubMed
28.
Menge TJ, Boykin RE, Bushnell BD, Byram IR (2014) Acromioclavicular osteoarthritis: a common cause of shoulder pain. South Med J 107:324–329PubMed
29.
Morikawa D, Dyrna F, Cote MP, Johnson JD, Obopilwe E, Imhoff FB, Beitzel K, Mazzocca AD, Scheiderer B (2019) Repair of the entire superior acromioclavicular ligament complex best restores posterior translation and rotational stability. Knee Surg Sports TraumatolArthrosc 27:3764–3770
30.
Muench LN, Kia C, Jerliu A, Murphy M, Berthold DP, Cote MP, Arciero RA, Mazzocca AD (2019) Functional and radiographic outcomes after anatomic coracoclavicular ligament reconstruction for type III/V acromioclavicular joint injuries. Orthop J Sports Med 7:2325967119884539PubMedPubMedCentral
31.
Nakazawa M, Nimura A, Mochizuki T, Koizumi M, Sato T, Akita K (2016) The orientation and variation of the acromioclavicular ligament: an anatomic study. Am J Sports Med 44:2690–2695PubMed
32.
Nolte PC, Lacheta L, Dekker TJ, Elrick BP, Millett PJ (2020) Optimal management of acromioclavicular dislocation: current perspectives. Orthop Res Rev 12:27–44PubMedPubMedCentral
33.
Padua R, Padua L, Ceccarelli E, Bondi R, Alviti F, Castagna A (2010) Italian version of ASES questionnaire for shoulder assessment: cross-cultural adaptation and validation. MusculoskeletSurg 94(Suppl 1):S85–90
34.
Padua R, Padua L, Ceccarelli E, Romanini E, Zanoli G, Amadio P, Campi A (2003) Italian version of the disability of the arm, shoulder and hand (dash) questionnaire. cross-cultural adaptation and validation. J Hand Surg Br 28:179–186PubMed
35.
Palauro FR, Stirma GA, Secundino AR, Riffel GB, Baracho F, Dau L (2019) Kirschner wire migration after the treatment of acromioclavicular luxation for the contralateral shoulder - case report. Rev Bras Ortop (Sao Paulo) 54:202–205
36.
Pallis M, Cameron KL, Svoboda SJ, Owens BD (2012) Epidemiology of acromioclavicular joint injury in young athletes. Am J Sports Med 40:2072–2077PubMed
37.
Rockwood CJ, Williams G, Young D (1998) Disorders of the acromioclavicular joint. In: Rockwood CJ, Matsen FA (eds) The Shoulder, 2nd edn. WB Saunders, Philadelphia, pp 483–553
38.
Saccomanno MF, Fodale M, Capasso L, Cazzato G, Milano G (2014) Reconstruction of the coracoclavicular and acromioclavicular ligaments with semitendinosus tendon graft: a pilot study. Joints 2:6–14PubMedPubMedCentral
39.
Scheibel M, Dröschel S, Gerhardt C, Kraus N (2011) Arthroscopically assisted stabilization of acute high-grade acromioclavicular joint separations. Am J Sports Med 39:1507–1516PubMed
40.
Shaffer BS (1999) Painful conditions of the acromioclavicular joint. J Am AcadOrthopSurg 7:176–188
41.
Shin S-J, Campbell S, Scott J, McGarry MH, Lee TQ (2014) Simultaneous anatomic reconstruction of the acromioclavicular and coracoclavicular ligaments using a single tendon graft. Knee Surg Sports TraumatolArthrosc 22:2216–2222
42.
Stine IA, Vangsness CT (2009) Analysis of the capsule and ligament insertions about the acromioclavicular joint: a cadaveric study. Arthroscopy 25:968–974PubMed
43.
Taft TN, Wilson FC, Oglesby JW (1987) Dislocation of the acromioclavicular joint. An end-result study. J Bone Joint Surg Am 69:1045–1051PubMed
44.
Tauber M, Valler D, Lichtenberg S, Magosch P, Moroder P, Habermeyer P (2016) Arthroscopic stabilization of chronic acromioclavicular joint dislocations: triple- versus single-bundle reconstruction. Am J Sports Med 44:482–489PubMed
45.
Tavakkolizadeh A, Ghassemi A, Colegate-Stone T, Latif A, Sinha J (2009) Gender-specific constant score correction for age. Knee Surg Sports TraumatolArthrosc 17:529–533
46.
Thangaraju S, Tauber M, Habermeyer P, Martetschläger F (2019) Clavicle and coracoid process periprosthetic fractures as late post-operative complications in arthroscopically assisted acromioclavicular joint stabilization. Knee Surg Sports TraumatolArthrosc 27:3797–3802
47.
Virtanen KJ, Savolainen V, Tulikoura I, Remes V, Haapamäki V, Pajarinen J, Björkenheim J-M, Paavola M (2014) Surgical treatment of chronic acromioclavicular joint dislocation with autogenous tendon grafts. Springerplus 3:420PubMedPubMedCentral
48.
Wang Y, Zhang J (2014) Acromioclavicular joint reconstruction by coracoid process transfer augmented with hook plate. Injury 45:949–954PubMed
49.
Weinstein DM, McCann PD, McIlveen SJ, Flatow EL, Bigliani LU (1995) Surgical treatment of complete acromioclavicular dislocations. Am J Sports Med 23:324–331PubMed
50.
Xará-Leite F, Andrade R, Moreira PS, Coutinho L, Ayeni OR, Sevivas N, Espregueira-Mendes J (2019) Anatomic and non-anatomic reconstruction improves post-operative outcomes in chronic acromio-clavicular instability: a systematic review. Knee Surg Sports TraumatolArthrosc 27:3779–3796
51.
Yeak RD, Daud H, Nizlan NM (2019) Osteomyelitis post acromioclavicular joint reconstruction. Chin J Traumatol 22:182–185PubMedPubMedCentral
Metadata
Title
Anatomic reconstruction of the coracoclavicular and acromioclavicular ligaments with semitendinosus tendon graft for the treatment of chronic acromioclavicular joint dislocation provides good clinical and radiological results
Authors
Maristella F. Saccomanno
Giacomo Marchi
Fabrizio Mocini
Valeria Vismara
Vincenzo Campana
Andrea G. Salvi
Alessandra Scaini
Giuseppe Milano
Publication date
01-07-2021
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 7/2021
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-020-06285-x

Other articles of this Issue 7/2021

Knee Surgery, Sports Traumatology, Arthroscopy 7/2021 Go to the issue

SHOULDER

Reliable diagnosis of posterosuperior rotator cuff tears requires a combination of clinical tests

SHOULDER

Low rate of recurrent instability following the open Latarjet procedure as a revision procedure for failed prior stabilization surgery

SHOULDER

Arthroscopic reduction and subscapularis remplissage (ARR) of chronic posterior locked shoulder dislocation leads to optimized outcomes and low rate of complications

SHOULDER

Acromioclavicular joint arthritis is not an indication for routine distal clavicle excision in arthroscopic rotator cuff repair

SHOULDER

The morphological stenosis pattern of the suprascapular notch is revealed yielding higher incidence in the discrete type and elucidating the inevitability of osteoplasty in horizontally oriented stenosis

Shoulder

The acromiohumeral distance in the MRI should not be used as a decision criterion to assess subacromial space width in shoulders with an intact rotator cuff