Anatomic Coracoclavicular Ligament Reconstruction for the Treatment of Acute Acromioclavicular Joint Dislocation

Daisuke, Mori; Yamashita, Fumiyoshi; Kizaki, Kazuha; Funakoshi, Noboru; Mizuno, Yasuyuki; Kobayashi, Masahiko

doi:10.2106/jbjs.oa.16.00007

Cited by 16 publications

(25 citation statements)

References 34 publications

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“…A study reported a lower angle seemed to achieve better clinical outcomes [21]. The direction of the clavicular tunnel and the coracoid tunnel should be strictly monitored [21,22]. In our study, we found the mean CCα angle was 8.2 °.…”

Section: Discussionsupporting

confidence: 46%

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Anchor moored positioning technique by suture anchor and Endobutton fixation for treatment of acromioclavicular joint dislocation

Ying¹,

Shen²,

Wang³

2019

Preprint

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Background Numerous surgical methods have been used for acromioclavicular joint reconstruction.In this study, we analyzed the clinical and radiographic outcomes of truly anatomic coracoclavicular ligaments reconstruction (TACCR) and truly anatomic acromioclavicular ligaments reconstruction (TAACR) using suture anchor and Endobutton fixation for treatment of acromioclavicular joint dislocation. Methods 48 patients (mean age 49 years) with severe acromioclavicular joint dislocation. The patients were classified as Rockwood type III (n=28), IV (n=3) and V (n=17). All patients were operatively treated using anchor moored positioning technique by suture anchor and Endobutton fixation. Clinical and radiographic evaluation include the visual analog scale (VAS), Constant scores (CS) and American Shoulder and Elbow Surgeons (ASES) scores and radiographic outcomes. Results The mean follow-up was 34 months. The VAS decreased from 5 preoperatively to 0 at 24 months (P < .001). The CS and ASES scores improved from 43, 44 preoperatively to 96, 97 at 24 months separately (P < .001). Meanwhile, 47 patients (97.9%) demonstrated stable anatomical fixation on final postoperative radiographs. Loss of reduction occurred in 1 patient (2.1%), but was not correlated with functional outcome. Conclusions Anchor moored positioning technique with Bi-directional fixations by suture anchor and Endobutton fixation represents a new and reliable treatment of AC joint dislocation.

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Section: Discussionsupporting

confidence: 46%

“…Third, the angle between the midlines of the clavicle bone tunnel and the coracoid bone tunnel (CCα) should be close to 0°. A study reported a lower angle seemed to achieve better clinical outcomes [21]. The direction of the clavicular tunnel and the coracoid tunnel should be strictly monitored [21,22].…”

Section: Discussionmentioning

confidence: 98%

Anchor moored positioning technique by suture anchor and Endobutton fixation for treatment of acromioclavicular joint dislocation

Ying¹,

Shen²,

Wang³

2019

Preprint

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“…When instability, pain, and/or dysfunction remains despite appropriate nonoperative measures, surgical reconstruction should be considered. Previously described techniques focus on stabilization in the setting traumatic injury to the AC joint 17 , 18 . In a recent systematic review, Moatshe et al 11 .…”

Section: Discussionmentioning

confidence: 99%

Distal Clavicular Augmentation with Acromioclavicular and Coracoclavicular Ligament Reconstruction in the Setting of Iatrogenic Induced Acromioclavicular Instability

Peebles

Dekker

Akamefula

et al. 2019

Arthroscopy Techniques

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Although chronic pain and dysfunction of the acromioclavicular (AC) joint can reliably be treated with distal clavicle excision, disruption of the local stabilizing ligamentous structures may result in iatrogenic instability of the joint. Iatrogenic AC joint instability is a rare condition caused by over resection of the distal clavicle with unintended injury to the stabilizing ligaments in the treatment of AC joint pain. Addressing postresection instability can prove to be difficult because most reconstruction techniques are intended for patients with traumatic AC joint instability with the goal of creating an anatomically stable joint. However, in the setting of iatrogenic instability, the decreased bone stock of the distal clavicle results in instability of the AC joint, especially in the horizontal plane, and may cause these techniques to fail. Thus, operative management must aim to correct both the osseous and ligamentous deficits responsible for the genesis of this instability. In this Technical Note, we describe bony augmentation of the distal clavicle with an iliac crest bone autograft for chronic iatrogenic acromioclavicular joint instability with concomitant reconstruction of the AC and coracoclavicular ligaments.

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“…CC ligament reconstruction for the treatment of acute AC joint dislocation results in successful long-term clinical and radiographic outcomes. 29 The disadvantage of this technique is violation of the deltoid, which can be avoided by gentle dissection and good closure.…”

Section: Discussionmentioning

confidence: 99%

Open Anatomic Coracoclavicular Ligament Reconstruction by Modified Conjoint Tendon Transfer for Treatment of Acute High-Grade Acromioclavicular Dislocation

Selim

2018

Arthroscopy Techniques

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There is no ideal surgical technique for the treatment of acromioclavicular (AC) dislocations. Reconstruction of the coracoclavicular ligaments (CCLs) for the treatment of AC dislocations is evolving. Many techniques for CCL reconstruction have been described. They differ mainly in the method of fixation, number of tunnels, and graft used. The surgeon should select among hamstring autograft reconstruction, coracoacromial ligament transfer, and conjoint tendon transfer for CCL reconstruction. Early on, conjoint tendon transfer to the lateral clavicle was described for the treatment of high-grade AC dislocation. Dynamic instability occurred with poor long-term outcomes. The procedure was abandoned. Recently, proximally based conjoint tendon transfer for CCL reconstruction was described, but the technique is nonanatomic and leads to anterior displacement of the clavicle and malreduction. This article describes modified conjoint tendon transfer. The technique may yield stable, anatomic, biological reconstruction of the CCL for the treatment of acute high-grade AC dislocation. It consists of the following steps: (1) creation of clavicular holes, (2) coracoid osteotomy, (3) conjoint tendon mobilization, (4) conjoint tendon transfer and fixation to the CCL footprint on the undersurface of the clavicle, and (5) AC reduction and conjoint tendon tenodesis to the bed of the retained coracoid process.

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Anatomic Coracoclavicular Ligament Reconstruction for the Treatment of Acute Acromioclavicular Joint Dislocation

Cited by 16 publications

References 34 publications

Anchor moored positioning technique by suture anchor and Endobutton fixation for treatment of acromioclavicular joint dislocation

Anchor moored positioning technique by suture anchor and Endobutton fixation for treatment of acromioclavicular joint dislocation

Distal Clavicular Augmentation with Acromioclavicular and Coracoclavicular Ligament Reconstruction in the Setting of Iatrogenic Induced Acromioclavicular Instability

Open Anatomic Coracoclavicular Ligament Reconstruction by Modified Conjoint Tendon Transfer for Treatment of Acute High-Grade Acromioclavicular Dislocation

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