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Published in: European Journal of Orthopaedic Surgery & Traumatology 5/2012

01-07-2012 | Original Article

Arthroscopic acromioclavicular joint reconstruction using a synthetic ligament device

Authors: Jean Kany, Rajkumar S. Amaravathi, Regis Guinand, Philippe Valenti

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 5/2012

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Abstract

Purpose

To describe an all-arthroscopic treatment of acromioclavicular joint (ACJ) dislocation and report the clinical results of the procedure.

Methods

This study consisted of 54 patients of whom 49 were men and 5 were women. The age of the patients averaged 39 years (range 16–69 years). All the symptomatic acute and chronic acromioclavicular joint dislocations classified according to Rockwood type III–IV were included in the study. All of them underwent standard clinical and radiological examination.

Result

All the patients were regularly followed up at the institute with the average follow-up being 15.09 months (range 5–30 months). The results were assessed using the shoulder subjective value (SSV) and the Modified rating of the University of California Los Angeles (UCLA) for acromioclavicular joint. The mean pre-operative SSV improved from 35.65 to the post-operative value of 88.6. According to the UCLA scale, 40 excellent, 8 good, 4 fair and 2 poor results were achieved. There were few problems encountered with the procedure like failure of ligament, incomplete reduction, capsulitis, and migration of sleeve and fracture clavicle.

Conclusion

ACJ dislocations can effectively be treated with arthroscopy-assisted procedure. Since this procedure has given uniformly good to excellent results comparable to open reconstructive procedures, it can be a good treatment option for symptomatic ACJ dislocations.

Level of evidence

IV, therapeutic series.
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Literature
1.
go back to reference Bearn JG (1967) Direct observations on the function of the capsule of the sterno-clavicular joint in clavicular support. J Anat 101:159–170 (PMID 6047697)PubMed Bearn JG (1967) Direct observations on the function of the capsule of the sterno-clavicular joint in clavicular support. J Anat 101:159–170 (PMID 6047697)PubMed
2.
go back to reference Bezer M, Saygi B, Aydin N, Kukukdurmaz F, Ekuisi G, Guven O (2009) Quantification of acromioclavicular reduction parameters after the Weaver-Dunn procedure. Arch Orthop Trauma Surg 129:1017–1024 (PMID 18719931)PubMedCrossRef Bezer M, Saygi B, Aydin N, Kukukdurmaz F, Ekuisi G, Guven O (2009) Quantification of acromioclavicular reduction parameters after the Weaver-Dunn procedure. Arch Orthop Trauma Surg 129:1017–1024 (PMID 18719931)PubMedCrossRef
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 26:149–160 (PMID 20141978)PubMedCrossRef 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 26:149–160 (PMID 20141978)PubMedCrossRef
4.
go back to reference Bostrom Windhamre HA, VonHeideken JP, Une-Larsson VE, Ekelund AL (2010) Surgical treatment of chronic acromioclavicular joint dislocations: comparative studies of Weaver-Dunn augmented with PDS braid or hook plate. J Shoulder Elbow Surg 19:1040–1048 (PMID 20452245)PubMedCrossRef Bostrom Windhamre HA, VonHeideken JP, Une-Larsson VE, Ekelund AL (2010) Surgical treatment of chronic acromioclavicular joint dislocations: comparative studies of Weaver-Dunn augmented with PDS braid or hook plate. J Shoulder Elbow Surg 19:1040–1048 (PMID 20452245)PubMedCrossRef
5.
go back to reference Browne JE, Stanley RF, Tullos HS (1977) Acromioclavicular joint dislocations: comparative results following operative treatment with and without primary distal clavisectomy. Am J Sports Med 5:258–263 (PMID 931040)PubMedCrossRef Browne JE, Stanley RF, Tullos HS (1977) Acromioclavicular joint dislocations: comparative results following operative treatment with and without primary distal clavisectomy. Am J Sports Med 5:258–263 (PMID 931040)PubMedCrossRef
6.
go back to reference Carofino BC, Mazzocca AD (2010) The anatomic coracoclavicular ligament reconstruction: surgical technique and indications. J Shoulder Elbow Surg 19:37–46 (PMID 20188267)PubMedCrossRef Carofino BC, Mazzocca AD (2010) The anatomic coracoclavicular ligament reconstruction: surgical technique and indications. J Shoulder Elbow Surg 19:37–46 (PMID 20188267)PubMedCrossRef
7.
go back to reference Clayer M, Slavotinek CJ, Krishnan J (1997) The results of coracoclavicular slings for acromioclavicular dislocation. Aust NZ J Surg 67:343–436 (PMID 9193270)CrossRef Clayer M, Slavotinek CJ, Krishnan J (1997) The results of coracoclavicular slings for acromioclavicular dislocation. Aust NZ J Surg 67:343–436 (PMID 9193270)CrossRef
8.
go back to reference Clavenger T, Vance RE, Bachus KN, Burks RT, Tashjian RZ (2011) Biomechanical comparison of acromioclavicular joint reconstruction using coracoclavicular tendon grafts with or without coracoacromial ligament transfer. Arthroscopy 27:24–30 (PMID 20950988)CrossRef Clavenger T, Vance RE, Bachus KN, Burks RT, Tashjian RZ (2011) Biomechanical comparison of acromioclavicular joint reconstruction using coracoclavicular tendon grafts with or without coracoacromial ligament transfer. Arthroscopy 27:24–30 (PMID 20950988)CrossRef
9.
go back to reference Costic RS, Labriola JE, Rodosky MW, Debski RE (2004) Biomechanical rationale for development of anatomical reconstructions of coracoclavicular ligaments after complete acromioclavicular dislocations. Am J Sports Med 32:1929–1936 (PMID 15572323)PubMedCrossRef Costic RS, Labriola JE, Rodosky MW, Debski RE (2004) Biomechanical rationale for development of anatomical reconstructions of coracoclavicular ligaments after complete acromioclavicular dislocations. Am J Sports Med 32:1929–1936 (PMID 15572323)PubMedCrossRef
10.
go back to reference Dias JJ, Steingold RF, Richardson RA, Tesfayohanna B, Gregg PJ (1987) The conservative treatment of acromioclavicular dislocation. Review after 5 years. J Bone Joint Surg Br 69:719–722 (PMID 680330)PubMed Dias JJ, Steingold RF, Richardson RA, Tesfayohanna B, Gregg PJ (1987) The conservative treatment of acromioclavicular dislocation. Review after 5 years. J Bone Joint Surg Br 69:719–722 (PMID 680330)PubMed
11.
go back to reference Fraser-Moodie JA, Shortt NL, Robinson CM (2008) Injuries to the acromioclavicular joint. J Bone Joint Surg Br 90:697–707 (PMID 18539661)PubMedCrossRef Fraser-Moodie JA, Shortt NL, Robinson CM (2008) Injuries to the acromioclavicular joint. J Bone Joint Surg Br 90:697–707 (PMID 18539661)PubMedCrossRef
12.
go back to reference Fukuda K, Craig EV, An N, Cofield RH, Chao EY (1986) Biomechanical study of the ligamentous system of the acromioclavicular joint. J Bone Joint Surg Am 68:434–440 (PMID 3949839)PubMed Fukuda K, Craig EV, An N, Cofield RH, Chao EY (1986) Biomechanical study of the ligamentous system of the acromioclavicular joint. J Bone Joint Surg Am 68:434–440 (PMID 3949839)PubMed
14.
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 33:1723–1728. doi:1177/0363546505275646 PubMedCrossRef Grutter PW, Petersen SA (2005) Anatomical acromioclavicular ligament reconstruction. A biomechanical comparison of reconstructive techniques of the acromioclavicular joint. Am J Sports Med 33:1723–1728. doi:1177/​0363546505275646​ PubMedCrossRef
15.
go back to reference Guy DK, Wirth MA, Griffin JL, Rockwood CA (1998) Reconstruction of chronic and complete dislocation of the acromioclavicular joint. Clin Orthop Relat Res 347:138–149 (PMID 9520884)PubMedCrossRef Guy DK, Wirth MA, Griffin JL, Rockwood CA (1998) Reconstruction of chronic and complete dislocation of the acromioclavicular joint. Clin Orthop Relat Res 347:138–149 (PMID 9520884)PubMedCrossRef
16.
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 28:103–108 (PMID 10653552)PubMed 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 28:103–108 (PMID 10653552)PubMed
18.
go back to reference Jari R, Costic RS, Rodosky MW, Debski RE (2004) Biomechanical function of surgical procedures for acromioclavicular joint dislocations. Arthroscopy 20:237–245 (PMID 15007312)PubMedCrossRef Jari R, Costic RS, Rodosky MW, Debski RE (2004) Biomechanical function of surgical procedures for acromioclavicular joint dislocations. Arthroscopy 20:237–245 (PMID 15007312)PubMedCrossRef
19.
go back to reference Kippe MA, Demetropoulos CK, Baker KC, Jurist KA, Guettlier JH (2009) Failure of coracoclavicular artificial graft reconstruction from repetitive rotation. Arthroscopy 25:975–982 (PMID 19732635)PubMedCrossRef Kippe MA, Demetropoulos CK, Baker KC, Jurist KA, Guettlier JH (2009) Failure of coracoclavicular artificial graft reconstruction from repetitive rotation. Arthroscopy 25:975–982 (PMID 19732635)PubMedCrossRef
20.
21.
go back to reference Lim YW (2008) Triple endobutton technique in acromioclavicular joint reduction and reconstruction. Ann Acad Med Singapore 37:294–299 (PMID 18461213)PubMed Lim YW (2008) Triple endobutton technique in acromioclavicular joint reduction and reconstruction. Ann Acad Med Singapore 37:294–299 (PMID 18461213)PubMed
22.
go back to reference Mathieu L, Rongieras F, Fascia P, Ollat D, Chauvin F, Versier G (2007) Acromioclavicular dislocations treated by synthetic coraco-clavicular ligamentoplasty. Rev Chir Orthop 93:116–125 (French, PMID 17401284)PubMed Mathieu L, Rongieras F, Fascia P, Ollat D, Chauvin F, Versier G (2007) Acromioclavicular dislocations treated by synthetic coraco-clavicular ligamentoplasty. Rev Chir Orthop 93:116–125 (French, PMID 17401284)PubMed
23.
go back to reference Mazzocca AD, Santangelo SA, Johnson ST, Rios CG, Dumonski ML, Arciero RA (2006) A biomechanical evaluation of an anatomical coracoclavicular ligament reconstruction. Am J Sports Med 34:236–246 (PMID 16282577)PubMedCrossRef Mazzocca AD, Santangelo SA, Johnson ST, Rios CG, Dumonski ML, Arciero RA (2006) A biomechanical evaluation of an anatomical coracoclavicular ligament reconstruction. Am J Sports Med 34:236–246 (PMID 16282577)PubMedCrossRef
24.
go back to reference Mazzocca AD, Arciero RA, Bicos J (2007) Evaluation and treatment of acromioclavicular injuries. Am J Sports Med 35:316–319 (PMID 17251175)PubMedCrossRef Mazzocca AD, Arciero RA, Bicos J (2007) Evaluation and treatment of acromioclavicular injuries. Am J Sports Med 35:316–319 (PMID 17251175)PubMedCrossRef
25.
go back to reference Motamedi AR, Blevin FT, Wills MC, McNally TP, Shahinpoor M (2000) Biomechanics of the coracoclavicular ligament complex and augmentations used in its repair and reconstruction. Am J Sports Med 28:380–384 (PMID 10843132)PubMed Motamedi AR, Blevin FT, Wills MC, McNally TP, Shahinpoor M (2000) Biomechanics of the coracoclavicular ligament complex and augmentations used in its repair and reconstruction. Am J Sports Med 28:380–384 (PMID 10843132)PubMed
26.
go back to reference Nordqvist A, Petersen CJ (1995) Incidence and causes of shoulder girdle injuries in an urban population. J Shoulder Elbow Surg 4:107–112 (PMID 8792740)PubMedCrossRef Nordqvist A, Petersen CJ (1995) Incidence and causes of shoulder girdle injuries in an urban population. J Shoulder Elbow Surg 4:107–112 (PMID 8792740)PubMedCrossRef
27.
go back to reference Rockwood CA Jr, Williams GR, Young DC (1996) Injuries to the acromioclavicular joint. In: Rockwood CA, Green DP, Buchholz RW et al (eds) Fracture in adults, vol 2, 4th edn. Lippincott-Raven, Philadelphia, pp 1341–1413 Rockwood CA Jr, Williams GR, Young DC (1996) Injuries to the acromioclavicular joint. In: Rockwood CA, Green DP, Buchholz RW et al (eds) Fracture in adults, vol 2, 4th edn. Lippincott-Raven, Philadelphia, pp 1341–1413
28.
go back to reference Rolf O, VonWeyhern AH, Ewers A, Boehm TD, Gohlke F (2008) Acromioclavicular dislocation Rockwood III–IV. Results of early versus delayed surgical treatment. Arch Orthop Trauma Surg 128:1153–1157 (PMID 18038141)PubMedCrossRef Rolf O, VonWeyhern AH, Ewers A, Boehm TD, Gohlke F (2008) Acromioclavicular dislocation Rockwood III–IV. Results of early versus delayed surgical treatment. Arch Orthop Trauma Surg 128:1153–1157 (PMID 18038141)PubMedCrossRef
29.
go back to reference Shin YJ, Yun YH, Yoo JD (2009) Coracoclavicular ligament reconstruction for acromioclavicular dislocation using 2 suture anchors and coracoacromial ligament transfer. Am J Sports Med 37:346–351 (PMID 19022989)PubMedCrossRef Shin YJ, Yun YH, Yoo JD (2009) Coracoclavicular ligament reconstruction for acromioclavicular dislocation using 2 suture anchors and coracoacromial ligament transfer. Am J Sports Med 37:346–351 (PMID 19022989)PubMedCrossRef
30.
go back to reference Tauber M, Gordon K, Koller H, Fox M, Resch H (2009) Semitendinous tendon graft versus a modified Weaver-Dunn procedure for acromioclavicular joint reconstruction in chronic cases. A prospective comparative study. Am J Sports Med 37:181–190 (PMID 18818433)PubMedCrossRef Tauber M, Gordon K, Koller H, Fox M, Resch H (2009) Semitendinous tendon graft versus a modified Weaver-Dunn procedure for acromioclavicular joint reconstruction in chronic cases. A prospective comparative study. Am J Sports Med 37:181–190 (PMID 18818433)PubMedCrossRef
31.
go back to reference Wellmann M, Zantop T, Wellmann A, Raschke MJ, Petersen W (2007) Biomechanical evaluation of minimally invasive repairs for complete acromioclavicular joint dislocation. Am J Sports Med 35:955–961 (PMID 17322128)PubMedCrossRef Wellmann M, Zantop T, Wellmann A, Raschke MJ, Petersen W (2007) Biomechanical evaluation of minimally invasive repairs for complete acromioclavicular joint dislocation. Am J Sports Med 35:955–961 (PMID 17322128)PubMedCrossRef
32.
go back to reference Weinstein DM, McCann PD, McIIveen SJ, Flatow EL, Bigliani LU (1995) Surgical treatment of complete acromioclavicular dislocations. Am J Sports Med 23:324–331 (PMID 7661261)PubMedCrossRef Weinstein DM, McCann PD, McIIveen SJ, Flatow EL, Bigliani LU (1995) Surgical treatment of complete acromioclavicular dislocations. Am J Sports Med 23:324–331 (PMID 7661261)PubMedCrossRef
33.
go back to reference Wolf EM, Pennington WT (2001) Arthroscopic reconstruction for acromioclavicular joint dislocation. Arthroscopy 17:558–563 (PMID 11337730)PubMedCrossRef Wolf EM, Pennington WT (2001) Arthroscopic reconstruction for acromioclavicular joint dislocation. Arthroscopy 17:558–563 (PMID 11337730)PubMedCrossRef
34.
go back to reference Yoo YS, Tsai AG, Ranawat AS, Bansal M, Fu F, Rodosky MW, Smolinski P (2010) A biomechanical analysis of the native coracoclavicular ligaments and their influence on a new reconstruction using a coracoid tunnel and free tendon graft. Arthroscopy 26:1153–1161 (PMID 20810076)PubMedCrossRef Yoo YS, Tsai AG, Ranawat AS, Bansal M, Fu F, Rodosky MW, Smolinski P (2010) A biomechanical analysis of the native coracoclavicular ligaments and their influence on a new reconstruction using a coracoid tunnel and free tendon graft. Arthroscopy 26:1153–1161 (PMID 20810076)PubMedCrossRef
Metadata
Title
Arthroscopic acromioclavicular joint reconstruction using a synthetic ligament device
Authors
Jean Kany
Rajkumar S. Amaravathi
Regis Guinand
Philippe Valenti
Publication date
01-07-2012
Publisher
Springer-Verlag
Published in
European Journal of Orthopaedic Surgery & Traumatology / Issue 5/2012
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI
https://doi.org/10.1007/s00590-011-0856-0

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