Acromioclavicular joint reconstruction implants have differing ability to restore horizontal and vertical plane stability

Alkoheji, Mohamed; El-Daou, Hadi; Lee, Jillian; Carlos, Adrian; Mascio, Livio Di; Amis, Andrew A.

doi:10.1007/s00167-021-06700-x

Cited by 3 publications

(1 citation statement)

References 25 publications

(35 reference statements)

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“… 39 Recent cadaveric studies showed that native stability in the horizontal and vertical planes can be restored in anterior, posterior, superior, and inferior stability measures when performing suture or button reconstruction that passed directly through tunnels in the clavicle and coracoid, compared to tape implants wrapped around the bones. 49 The only level 2 study that was described in this review showed superior results when ACJ reconstruction was performed with a tendon graft. 50 This prospective randomized comparative study showed that chronic dislocation using a semitendinosus allograft, compared to synthetic stabilization (Ligament Augmentation and Reconstruction System), had better clinical scores on one- and four-year follow-up.…”

Section: Resultsmentioning

confidence: 81%

Management of Acromioclavicular Injuries – Current Concepts

Groot¹,

Verstift²,

Heisen³

et al. 2023

ORR

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Introduction Treatment of a patient with acromioclavicular joint (ACJ) injury remains challenging for orthopedic surgeons. To date, there is debate over the optimal management of ACJ injuries. This review provides an overview of assessment, treatment, and future perspectives for the treatment of and research into ACJ. Material and Methods A scoping literature review was performed. The search was built including the following terms: acromioclavicular joint injuries or dislocation, and pathophysiology, etiology, anatomy, treatment, and trauma mechanism. The papers with evidence levels 1–3 were included in the current narrative review. Results A total of 2242 potential relevant studies were identified in the searches. After removal of duplicates, 432 studies were screened on their titles and abstracts, resulting in 35 studies being included in the review, based on the eligibility criteria. Conclusion The management of acute and chronic ACJ injuries is not clarified in the current literature. However, there is currently insufficient high-level evidence for the overall treatment options for ACJ injuries. If surgical intervention is decided upon in consultation with the patient, the complications may not outweigh the benefits. The multitude of existing techniques is indicative of the uncertainty surrounding this issue, and no gold standard has yet been established for treatment methods. An ideal classification would include not only vertical and horizontal instability, but also the severity of kinematic alterations of the shoulder complex. This indicates the need for a new and improved diagnostic tool for the classification of ACJ injuries.

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Section: Resultsmentioning

confidence: 81%

Management of Acromioclavicular Injuries – Current Concepts

Groot¹,

Verstift²,

Heisen³

et al. 2023

ORR

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Surgical treatment of the acromioclavicular joint dislocation: modern trends and prospects

Buryanov,

Сhekushyn,

Kvasha

2023

TRAUMA

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Background. Acromioclavicular joint dislocations constitute from 6.8 to 26.1 % of all dislocations and rank third after dislocations of the shoulder and forearm. In the structure of acute traumatic injuries to the shoulder girdle, the proportion of acromioclavicular joint dislocations is above 12 %. These injuries are more common in men of the most working age (from 30 to 40 years) and in athletes engaged in contact sports. Poor outcomes of surgical treatment vary from 9 to 12 %. The aim of the study: to determine modern principles of surgical treatment for acromioclavicular joint dislocations, problematic issues and advanced solutions. Materials and methods. Analysis of literature sources was carried out using PubMed, UpToDate, Scopus, Web of Science, MEDLINE, The Cochrane Library, Embase, Global Health, CyberLeninka databases by search: acromioclavicular joint dislocations, surgical treatment. Results. The most common classification of acromioclavicular joint dislocations is Rockwood classification that includes six dislocation types. Despite the quite detailed classification of injuries to the acromioclavicular ligament according to Rockwood, the Tossy classification is more simplified, but meets practical needs, and distinguishes three types of damage. Stabilization of the clavicle with metal structures is realized by fixing to the coracoid process or acromion of the scapula, the latter is a priority. The disadvantages of the most used metal fixators were identified that require their optimization and development of innovative structures. The reasoned direction regarding static stabilizer restoration is plastic replacement of both ligamentous complexes. Conclusions. A priority direction is to stabilize the clavicle by fixing its acromial end to the acromion of the scapula with metal structures among which a hook plate and the Weber method are the most used. However, significant disadvantages in their use necessitate the development of innovative designs. A promising direction for the restoration of static clavicle stabilizers is surgical methods that combine the restoration of the coracoclavicular and acromioclavicular ligaments. The objective need to create channels for grafts leads to a weakening in the mechanical strength of the bony structures, so research regarding the direction, diameter, and location of these channels requires further investigation.

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Anatomical and Biomechanical Role of Static Stabilizers of the Acromioclavicular Joint

Sobolevskiy,

Burianov,

Kvasha

et al. 2023

Wiad Lek

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The aim: To determine the anatomical and biomechanical significance of the static stabilizers of the acromioclavicular joint by conducting numerical modeling using the finite element method and experimental investigation Materials and methods: To ensure the study, modeling of the deformation processes of the clavicle and scapula systems with various combinations of ligament damage was conducted. The COMPAS-3D software package was used to build the simulation model, which allowed obtaining models that are closest to reality. To verify the results of the numerical modeling, corresponding studies of the mechanical characteristics and determination of the stiffness of the investigated systems were carried out using the upgraded TIRAtest-2151 testing stand Results: The stiffest system is the system in which all ligaments are intact, and the sequence of decreasing stiffness of the system is presented in the following order: damage to lig. trapezoideum; lig. conoideum; lig. claviculo-acoacromiale inferior; lig. claviculo-acoacromiale superior; the coracoclavicular ligament complex; the acromioclavicular ligament complex Conclusions: Static stabilizers in general, and their components in particular, are characterized by significant anatomical and functional features. The natural stabilization of the acromioclavicular joint is provided by their synergistic interaction, which is the basis for the development and implementation of surgical interventions, the scope of which includes the restoration of both ligament complexes. The loss of stiffness in the «clavicle-scapula» system is significantly more pronounced when lig. acromioclaviculare superior and inferior are damaged (8.5 N/mm) than when lig. conoideum and lig. trapezoideum are damaged (11.6 N/mm)

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Acromioclavicular joint reconstruction implants have differing ability to restore horizontal and vertical plane stability

Cited by 3 publications

References 25 publications

Management of Acromioclavicular Injuries – Current Concepts

Management of Acromioclavicular Injuries – Current Concepts

Surgical treatment of the acromioclavicular joint dislocation: modern trends and prospects

Anatomical and Biomechanical Role of Static Stabilizers of the Acromioclavicular Joint

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