Skip to main content
Top
Published in: European Journal of Medical Research 1/2013

Open Access 01-12-2013 | Research

Restoration of horizontal stability in complete acromioclavicular joint separations: surgical technique and preliminary results

Authors: Haoqing Li, Chuanshun Wang, Jiandong Wang, Kai Wu, Donghua Hang

Published in: European Journal of Medical Research | Issue 1/2013

Login to get access

Abstract

Background

Our purpose was to investigate the clinical efficacy of arthroscope-assisted acromioclavicular ligament reconstruction in combination with double endobutton coracoclavicular ligament reconstruction for the treatment of complete acromioclavicular joint dislocation.

Methods

During the period from February 2010 to October 2012, ten patients with Rockwood types IV and V acromioclavicular joint dislocation were hospitalized and nine were treated with acromioclavicular ligament reconstruction combined with double endobutton of coracoclavicular ligament reconstruction. The improvement in shoulder functions was assessed using a Constant score and visual analog scale (VAS) system.

Results

The mean follow-up period was 33.6 ± 5.4 months. The mean Constant scores improved from 25.2 ± 6.6 preoperatively to 92.4 ± 6.5 postoperatively, while the mean VAS score decreased from 5.9 ± 1.4 to 1.2 ± 0.9; significant differences were observed. The final follow-up revealed that excellent outcomes were achieved in eight patients and good outcome in two patients.

Conclusion

Arthroscope-assisted acromioclavicular ligament reconstruction in combination with double endobutton of coracoclavicular ligament reconstruction is an effective approach for treatment of acute complete acromioclavicular joint dislocation.
Appendix
Available only for authorised users
Literature
1.
go back to reference Mazzocca AD, Arciero RA, Bicos J: Evaluation and treatment of acromioclavicular joint injuries. Am J Sports Med 2007, 35: 316–329.CrossRefPubMed Mazzocca AD, Arciero RA, Bicos J: Evaluation and treatment of acromioclavicular joint injuries. Am J Sports Med 2007, 35: 316–329.CrossRefPubMed
2.
go back to reference Macdonald PB, Lapointe P: Acromioclavicular and sternoclavicular joint injuries. Orthop Clin North Am 2008, 39: 535–545. viii 10.1016/j.ocl.2008.05.003CrossRefPubMed Macdonald PB, Lapointe P: Acromioclavicular and sternoclavicular joint injuries. Orthop Clin North Am 2008, 39: 535–545. viii 10.1016/j.ocl.2008.05.003CrossRefPubMed
3.
go back to reference Collins DN: Disorders of the acromioclavicular joint. In The Shoulder. Volume 1. 4th edition. Edited by: Rockwood CA, Matson FA, Wirth MA, Lippitt SB, Fehringer EV, Sperling JW. Philadelphia: Saunders Elsevier; 2009:453–526. Collins DN: Disorders of the acromioclavicular joint. In The Shoulder. Volume 1. 4th edition. Edited by: Rockwood CA, Matson FA, Wirth MA, Lippitt SB, Fehringer EV, Sperling JW. Philadelphia: Saunders Elsevier; 2009:453–526.
4.
go back to reference Rios CG, Mazzocca AD: Acromioclavicular joint problems in athletes and new methods of management. Clin Sports Med 2008, 27: 763–788. 10.1016/j.csm.2008.06.006CrossRefPubMed Rios CG, Mazzocca AD: Acromioclavicular joint problems in athletes and new methods of management. Clin Sports Med 2008, 27: 763–788. 10.1016/j.csm.2008.06.006CrossRefPubMed
5.
go back to reference Lädermann A, Grosclaude M, Lübbeke A, Christofilopoulos P, Stern R, Rod T, Hoffmeyer P: Acromioclavicular and coracoclavicular cerclage reconstruction for acute acromioclavicular joint dislocations. J Shoulder Elbow Surg 2011, 20: 401–408. 10.1016/j.jse.2010.08.007CrossRefPubMed Lädermann A, Grosclaude M, Lübbeke A, Christofilopoulos P, Stern R, Rod T, Hoffmeyer P: Acromioclavicular and coracoclavicular cerclage reconstruction for acute acromioclavicular joint dislocations. J Shoulder Elbow Surg 2011, 20: 401–408. 10.1016/j.jse.2010.08.007CrossRefPubMed
6.
go back to reference Kim SH, Lee YH, Shin SH, Lee YH, Baek GH: Outcome of conjoined tendon and coracoacromial ligament transfer for the treatment of chronic type V acromioclavicular joint separation. Injury 2012, 43: 213–218. 10.1016/j.injury.2011.08.003CrossRefPubMed Kim SH, Lee YH, Shin SH, Lee YH, Baek GH: Outcome of conjoined tendon and coracoacromial ligament transfer for the treatment of chronic type V acromioclavicular joint separation. Injury 2012, 43: 213–218. 10.1016/j.injury.2011.08.003CrossRefPubMed
7.
go back to reference Debski RE, Parsons I, Woo SL, Fu FH: Effect of capsular injury on acromioclavicular joint mechanics. J Bone Joint Surg Am 2001, 83: 1344–1351.PubMed Debski RE, Parsons I, Woo SL, Fu FH: Effect of capsular injury on acromioclavicular joint mechanics. J Bone Joint Surg Am 2001, 83: 1344–1351.PubMed
8.
go back to reference Struhl S: Double endobutton technique for repair of complete acromioclavicular joint dislocations. Tech Shoulder Elbow Surg 2007, 8: 175–179. 10.1097/BTE.0b013e31815907a3CrossRef Struhl S: Double endobutton technique for repair of complete acromioclavicular joint dislocations. Tech Shoulder Elbow Surg 2007, 8: 175–179. 10.1097/BTE.0b013e31815907a3CrossRef
9.
go back to reference Constant CR, Murley AH: A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 1987, 214: 160–164.PubMed Constant CR, Murley AH: A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 1987, 214: 160–164.PubMed
10.
go back to reference Beitzel K, Sablan N, Chowaniec DM, Obopilwe E, Cote MP, Arciero RA, Mazzocca AD: Sequential resection of the distal clavicle and its effects on horizontal acromioclavicular joint translation. Am J Sports Med 2012, 40: 681–685. 10.1177/0363546511428880CrossRefPubMed Beitzel K, Sablan N, Chowaniec DM, Obopilwe E, Cote MP, Arciero RA, Mazzocca AD: Sequential resection of the distal clavicle and its effects on horizontal acromioclavicular joint translation. Am J Sports Med 2012, 40: 681–685. 10.1177/0363546511428880CrossRefPubMed
11.
go back to reference Klimkiewicz JJ, Williams GR, Sher JS, Karduna A, Des Jardins JD, Iannotti JP: The acromioclavicular capsule as a restraint to posterior translation of the clavicle: a biomechanical analysis. J Shoulder Elbow Surg 1999, 8: 119–124. 10.1016/S1058-2746(99)90003-4CrossRefPubMed Klimkiewicz JJ, Williams GR, Sher JS, Karduna A, Des Jardins JD, Iannotti JP: The acromioclavicular capsule as a restraint to posterior translation of the clavicle: a biomechanical analysis. J Shoulder Elbow Surg 1999, 8: 119–124. 10.1016/S1058-2746(99)90003-4CrossRefPubMed
12.
go back to reference Lee K-W, Debski RE, Chen C-H, Woo SL-Y, Fu FH: Functional evaluation of the ligaments at the acromioclavicular joint during anteroposterior and superoinferior translation. Am J Sports Med 1997, 25: 858–862. 10.1177/036354659702500622CrossRefPubMed Lee K-W, Debski RE, Chen C-H, Woo SL-Y, Fu FH: Functional evaluation of the ligaments at the acromioclavicular joint during anteroposterior and superoinferior translation. Am J Sports Med 1997, 25: 858–862. 10.1177/036354659702500622CrossRefPubMed
13.
go back to reference Gong X, Jiang C, Wang M: Diagnosis and treatment of acromioclavicular joint dislocation. Chin J Orthop 2005, 4: 240–244. Gong X, Jiang C, Wang M: Diagnosis and treatment of acromioclavicular joint dislocation. Chin J Orthop 2005, 4: 240–244.
14.
go back to reference Baker JE, Nicandri GT, Young DC, Owen JR, Wayne JS: A cadaveric study examining acromioclavicular joint congruity after different methods of coracoclavicular loop repair. J Shoulder Elbow Surg 2003, 12: 595–598. 10.1016/S1058-2746(03)00050-8CrossRefPubMed Baker JE, Nicandri GT, Young DC, Owen JR, Wayne JS: A cadaveric study examining acromioclavicular joint congruity after different methods of coracoclavicular loop repair. J Shoulder Elbow Surg 2003, 12: 595–598. 10.1016/S1058-2746(03)00050-8CrossRefPubMed
15.
go back to reference Gstettner C, Tauber M, Hitzl W, Resch H: Rockwood type III acromioclavicular dislocation: surgical versus conservative treatment. J Shoulder Elbow Surg 2008, 17: 220–225. 10.1016/j.jse.2007.07.017CrossRefPubMed Gstettner C, Tauber M, Hitzl W, Resch H: Rockwood type III acromioclavicular dislocation: surgical versus conservative treatment. J Shoulder Elbow Surg 2008, 17: 220–225. 10.1016/j.jse.2007.07.017CrossRefPubMed
16.
go back to reference Nadarajah R, Mahaluxmivala J, Amin A, Goodier D: Clavicular hook-plate: complications of retaining the implant. Injury 2005, 36: 681–683. 10.1016/j.injury.2004.08.010CrossRefPubMed Nadarajah R, Mahaluxmivala J, Amin A, Goodier D: Clavicular hook-plate: complications of retaining the implant. Injury 2005, 36: 681–683. 10.1016/j.injury.2004.08.010CrossRefPubMed
17.
go back to reference Kumar S, Penematsa S, Selvan T: Surgical reconstruction for chronic painful acromioclavicular joint dislocations. Arch Orthop Trauma Surg 2007, 127: 481–484. 10.1007/s00402-007-0298-7CrossRefPubMed Kumar S, Penematsa S, Selvan T: Surgical reconstruction for chronic painful acromioclavicular joint dislocations. Arch Orthop Trauma Surg 2007, 127: 481–484. 10.1007/s00402-007-0298-7CrossRefPubMed
18.
go back to reference Deshmukh AV, Wilson DR, Zilberfarb JL, Perlmutter GS: Stability of acromioclavicular joint reconstruction biomechanical testing of various surgical techniques in a cadaveric model. Am J Sports Med 2004, 32: 1492–1498. 10.1177/0363546504263699CrossRefPubMed Deshmukh AV, Wilson DR, Zilberfarb JL, Perlmutter GS: Stability of acromioclavicular joint reconstruction biomechanical testing of various surgical techniques in a cadaveric model. Am J Sports Med 2004, 32: 1492–1498. 10.1177/0363546504263699CrossRefPubMed
19.
go back to reference Grutter PW, Petersen SA: Anatomical acromioclavicular ligament reconstruction a biomechanical comparison of reconstructive techniques of the acromioclavicular joint. Am J Sports Med 2005, 33: 1723–1728. 10.1177/0363546505275646CrossRefPubMed Grutter PW, Petersen SA: Anatomical acromioclavicular ligament reconstruction a biomechanical comparison of reconstructive techniques of the acromioclavicular joint. Am J Sports Med 2005, 33: 1723–1728. 10.1177/0363546505275646CrossRefPubMed
20.
go back to reference Costic RS, Labriola JE, Rodosky MW, Debski RE: Biomechanical rationale for development of anatomical reconstructions of coracoclavicular ligaments after complete acromioclavicular joint dislocations. Am J Sports Med 2004, 32: 1929–1936. 10.1177/0363546504264637CrossRefPubMed Costic RS, Labriola JE, Rodosky MW, Debski RE: Biomechanical rationale for development of anatomical reconstructions of coracoclavicular ligaments after complete acromioclavicular joint dislocations. Am J Sports Med 2004, 32: 1929–1936. 10.1177/0363546504264637CrossRefPubMed
21.
go back to reference Jari R, Costic RS, Rodosky MW, Debski RE: Biomechanical function of surgical procedures for acromioclavicular joint dislocations. Arthroscopy 2004, 20: 237–245. 10.1016/j.arthro.2004.01.011CrossRefPubMed Jari R, Costic RS, Rodosky MW, Debski RE: Biomechanical function of surgical procedures for acromioclavicular joint dislocations. Arthroscopy 2004, 20: 237–245. 10.1016/j.arthro.2004.01.011CrossRefPubMed
22.
go back to reference Tauber M, Gordon K, Koller H, Fox M, Resch H: Semitendinosus tendon graft versus a modified Weaver-Dunn procedure for acromioclavicular joint reconstruction in chronic cases: a prospective comparative study. Am J Sports Med 2009, 37: 181–190.CrossRefPubMed Tauber M, Gordon K, Koller H, Fox M, Resch H: Semitendinosus tendon graft versus a modified Weaver-Dunn procedure for acromioclavicular joint reconstruction in chronic cases: a prospective comparative study. Am J Sports Med 2009, 37: 181–190.CrossRefPubMed
23.
go back to reference Freedman JA, Adamson GJ, Bui C, Lee TQ: Biomechanical evaluation of the acromioclavicular capsular ligaments and reconstruction with an intramedullary free tissue graft. Am J Sports Med 2010, 38: 958–964. 10.1177/0363546509355056CrossRefPubMed Freedman JA, Adamson GJ, Bui C, Lee TQ: Biomechanical evaluation of the acromioclavicular capsular ligaments and reconstruction with an intramedullary free tissue graft. Am J Sports Med 2010, 38: 958–964. 10.1177/0363546509355056CrossRefPubMed
24.
go back to reference Wei H-F, Chen Y-F, Zeng B-F, Zhang C-Q, Chai Y-M, Wang H-M, Lu Y: Triple endobutton technique for the treatment of acute complete acromioclavicular joint dislocations: preliminary results. Int Orthop 2011, 35: 555–559. 10.1007/s00264-010-1057-xPubMedCentralCrossRefPubMed Wei H-F, Chen Y-F, Zeng B-F, Zhang C-Q, Chai Y-M, Wang H-M, Lu Y: Triple endobutton technique for the treatment of acute complete acromioclavicular joint dislocations: preliminary results. Int Orthop 2011, 35: 555–559. 10.1007/s00264-010-1057-xPubMedCentralCrossRefPubMed
25.
go back to reference Zhao L, Zhang Y, Yin Z, Shi L, Wang L, Xue Q: The early results of total arthroscopic double endobutton technique for acute acromioclavicular joint dislocation. Chin J Joint Surg 2010, 4: 18–24. Zhao L, Zhang Y, Yin Z, Shi L, Wang L, Xue Q: The early results of total arthroscopic double endobutton technique for acute acromioclavicular joint dislocation. Chin J Joint Surg 2010, 4: 18–24.
26.
go back to reference Wellmann M, Zantop T, Petersen W: Minimally invasive coracoclavicular ligament augmentation with a flip button/polydioxanone repair for treatment of total acromioclavicular joint dislocation. Arthroscopy 2007, 23: 1132. e1131–1132. e1135.CrossRef Wellmann M, Zantop T, Petersen W: Minimally invasive coracoclavicular ligament augmentation with a flip button/polydioxanone repair for treatment of total acromioclavicular joint dislocation. Arthroscopy 2007, 23: 1132. e1131–1132. e1135.CrossRef
27.
go back to reference Venjakob AJ, Salzmann GM, Gabel F, Buchmann S, Walz L, Spang JT, Vogt S, Imhoff AB: Arthroscopically assisted 2-bundle anatomic reduction of acute acromioclavicular joint separations 58-month findings. Am J Sports Med 2013, 41: 615–621. 10.1177/0363546512473438CrossRefPubMed Venjakob AJ, Salzmann GM, Gabel F, Buchmann S, Walz L, Spang JT, Vogt S, Imhoff AB: Arthroscopically assisted 2-bundle anatomic reduction of acute acromioclavicular joint separations 58-month findings. Am J Sports Med 2013, 41: 615–621. 10.1177/0363546512473438CrossRefPubMed
28.
go back to reference Carofino BC, Mazzocca AD: The anatomic coracoclavicular ligament reconstruction: surgical technique and indications. J Shoulder Elbow Surg 2010, 19: 37–46. 10.1016/j.jse.2010.01.004CrossRefPubMed Carofino BC, Mazzocca AD: The anatomic coracoclavicular ligament reconstruction: surgical technique and indications. J Shoulder Elbow Surg 2010, 19: 37–46. 10.1016/j.jse.2010.01.004CrossRefPubMed
29.
go back to reference Renfree KJ, Riley MK, Wheeler D, Hentz JG, Wright TW: Ligamentous anatomy of the distal clavicle. J Shoulder Elbow Surg 2003, 12: 355–359. 10.1016/S1058-2746(03)00029-6CrossRefPubMed Renfree KJ, Riley MK, Wheeler D, Hentz JG, Wright TW: Ligamentous anatomy of the distal clavicle. J Shoulder Elbow Surg 2003, 12: 355–359. 10.1016/S1058-2746(03)00029-6CrossRefPubMed
Metadata
Title
Restoration of horizontal stability in complete acromioclavicular joint separations: surgical technique and preliminary results
Authors
Haoqing Li
Chuanshun Wang
Jiandong Wang
Kai Wu
Donghua Hang
Publication date
01-12-2013
Publisher
BioMed Central
Published in
European Journal of Medical Research / Issue 1/2013
Electronic ISSN: 2047-783X
DOI
https://doi.org/10.1186/2047-783X-18-42

Other articles of this Issue 1/2013

European Journal of Medical Research 1/2013 Go to the issue