Acromioclavicular joint dislocation: a comparative biomechanical study of the palmaris-longus tendon graft reconstruction with other augmentative methods in cadaveric models

Luis, Guntur E; Yong, Chee-Khuen; Singh, Deepak Ajit; Sengupta, S; Choon, David

doi:10.1186/1749-799x-2-22

Cited by 48 publications

(28 citation statements)

References 36 publications

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“…Superficial wound infection is not uncommon owing to the extensive soft-tissue damage and foreign body reaction to non-absorbable materials. [32][33][34] Other complications associated with the Surgilig include coracoid fracture, screw loosening in the clavicle, and distal clavicular osteolysis. 10,11,35 Limitations of our study included nonrandomisation, a small sample size, no objective assessment (although radiographic appearance does not correlate with the clinical outcome 22 ), and possible observational bias owing to lack of blinding.…”

Section: Discussionmentioning

confidence: 99%

Modified Weaver-Dunn Procedure versus the Use of a Synthetic Ligament for Acromioclavicular Joint Reconstruction

Kumar

Garg

Elzein

et al. 2014

J Orthop Surg (Hong Kong)

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PURPOSE. To compare the subjective outcome of acromioclavicular joint (ACJ) reconstruction using the modified Weaver-Dunn procedure versus the Surgilig synthetic ligament. METHODS. 55 patients aged 19 to 72 (mean, 42) years underwent ACJ reconstruction of Rockwood grade 3 (n=38), grade 4 (n=8), and grade 5 (n=9) using the modified Weaver-Dunn procedure (n=31) or the Surgilig synthetic ligament (n=24), based on the surgeon's preference. The mean period from injury to surgical treatment was 39 months. Subjective outcomes were assessed before and after surgery using the Oxford Shoulder score and Nottingham Clavicle score. The time required to return to work and sports was also recorded. RESULTS. After a mean follow-up period of 40 months, the mean Oxford Shoulder scores improved from 28 to 42 in the Weaver-Dunn group (p=0.009), and from 26 to 45 in the Surgilig group (p=0.007), whereas the respective mean Nottingham Clavicle scores improved from 53 to 81 (p=0.047) and from 51 to 93 (p=0.023). The Surgilig group achieved significantly better postoperative Oxford Shoulder score (p=0.008) and Nottingham Clavicle score (p=0.007), and could also return to work (14 vs. 6 weeks, p<0.001) and sports (25 vs. 12 weeks, p<0.001) sooner than the Weaver-Dunn group. Three patients in the Weaver- Dunn group and one patient in the Surgilig group had persistent pain and/or functional deficit with evidence of ACJ dislocation. CONCLUSION. Chronic ACJ reconstruction using the Surgilig synthetic ligament achieved better Oxford Shoulder score and Nottingham Clavicle score and earlier return to work and sports, compared with the modified Weaver-Dunn procedure.

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Section: Discussionmentioning

confidence: 99%

Modified Weaver-Dunn Procedure versus the Use of a Synthetic Ligament for Acromioclavicular Joint Reconstruction

Kumar

Garg

Elzein

et al. 2014

J Orthop Surg (Hong Kong)

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“…Modi et al 10) reported that the goal of fixation of ACJ is to restore the CCD in order to allow healing of the ruptured ligaments. Also, Luis et al 26) reported that coracoclavicular ligament repair is unnecessary with hook plates because anatomical reduction is done. Therefore, using hook plate in anatomical reduction of ACJ dislocation, which is advantageous for superoinferior displacement reduction, will normalize CCD and ACD to achieve superoinferior reduction and yield coracoclavicular ligament healing effect.…”

Section: Discussionmentioning

confidence: 99%

Clinical and Radiologic Outcomes of Acute Acromioclavicular Joint Dislocation: Comparison of Kirschner's Wire Transfixation and Locking Hook Plate Fixation

Rhee¹,

Park²,

Cho³

et al. 2014

Clinics in Shoulder and Elbow

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Background: Kirschner's wire (K-wire) transfixation and locking hook plate fixation techniques are widely used in the treatment of acute acromioclavicular joint (ACJ) dislocation. The purpose of this study was to compare the clinical and radiologic outcomes between K-wires transfixation and a locking hook plate fixation technique. Methods: Seventy-seven patients with acute ACJ dislocation managed with K-wire (56 shoulders) and locking hook plate (21 shoulders) were enrolled for this study. The mean follow-up period was 61 months. Results: At the last follow-up, the shoulder rating scale of the University of California at Los Angeles (UCLA) was higher in patients treated with locking hook plate than with K-wires (33.2 ± 2.7 vs. 31.3 ± 3.4, p=0.009). In radiologic assessments, coracoclavicular distance (CCD) (7.9 mm vs. 7.7 mm, p=0.269) and acromioclavicular distance (ACD) (3.0 mm vs. 1.9 mm, p=0.082) were not statistically different from contralateral unaffected shoulder in locking hook plate fixation group, but acromioclavicular interval (ACI) was significant difference. However, there were significant differences in ACI, CCD, and ACD in K-wire fixation group (p<0.001). Eleven complications (20%) occurred in K-wire transfixation group and 2 subacromial erosions on computed tomography scan occurred in locking hook plate fixation group. Conclusions: ACJ stabilization was achieved in acute ACJ dislocations treated with K-wires or locking hook plates. Locking hook plate can provide higher UCLA shoulder score than K-wire and maintain CCD, and ACD without ligament reconstruction. K-wire transfixation technique resulted in a higher complication rate than locking hook plate. (Clin Shoulder Elbow 2014;17(4):159-165)

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“…Furthermore, remove of the clavicular hook plate often induced recurrence of the AC joint dislocation. In all, the above fixation methods are non-anatomic reconstruction which cannot restore the anatomic structure of the CC ligament and AC ligament, and the anatomical functions cannot fully restore though the above problems are avoided post-operation [ 19 ].…”

Section: Discussionmentioning

confidence: 99%

Arthroscopy-assisted reconstruction of coracoclavicular ligament by Endobutton fixation for treatment of acromioclavicular joint dislocation

Pan

Sun

et al. 2014

Arch Orthop Trauma Surg

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ObjectiveThe aim of this study was to evaluate the clinical outcomes of arthroscopy-assisted reconstruction of the coracoclavicular (CC) ligament using Endobutton for treating acromioclavicular (AC) joint dislocation.MethodsFrom March 2012 to May 2013, a total of 22 patients with fresh AC joint dislocation (Rockwood type III and type V) were treated with arthroscopy-assisted Endobutton reconstruction of the CC ligament. The regular post-operation follow-up was performed. Shoulder joint function was assessed with Constant–Murley scores. Postoperative efficacy of the surgery was evaluated using the Karlsson criterion.ResultsThe 22 patients were followed postoperatively for an average of 24 months (16–31 months). Among them, 20 patients achieved good functional recovery with no pain. Two patients had slight pain in the acromion during shoulder joint motion with limited abduction at 3 months, both of whom had recovered at 6 months. Radiography confirmed anatomical reduction of the AC joint in all patients. At 1 year, the Constant–Murley scores were 93.1 ± 2.4 points on the injured side versus 94.2 ± 2.7 points on the uninjured side. The difference did not reach statistical significance (P > 0.05). Postoperative Karlsson evaluation ranked 20 patients (90.9 %) as grade A and 2 as grade B (9.1 %) at the 3-month follow-up. All patients had become grade A at 6 months. None of the patients had brachial plexus or peripheral vascular injuries.ConclusionArthroscopy-assisted reconstruction of the coracoclavicular ligament by Endobutton fixation is a safe, easy method for treating AC joint dislocation. It provides reliable fixation, causes little trauma, and has a fast recovery.

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Acromioclavicular joint dislocation: a comparative biomechanical study of the palmaris-longus tendon graft reconstruction with other augmentative methods in cadaveric models

Cited by 48 publications

References 36 publications

Modified Weaver-Dunn Procedure versus the Use of a Synthetic Ligament for Acromioclavicular Joint Reconstruction

Modified Weaver-Dunn Procedure versus the Use of a Synthetic Ligament for Acromioclavicular Joint Reconstruction

Clinical and Radiologic Outcomes of Acute Acromioclavicular Joint Dislocation: Comparison of Kirschner's Wire Transfixation and Locking Hook Plate Fixation

Arthroscopy-assisted reconstruction of coracoclavicular ligament by Endobutton fixation for treatment of acromioclavicular joint dislocation

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