Arthroscopic Acromioclavicular Fixation With Suture Tape Augmentation After Coracoclavicular Fixation With Dog Bone Button: Surgical Technique

Seo, Joong‐Bae; Heo, Kang; Kim, Seong-Jun; Jung, Jae-Uk; Yoo, Jae-Sung

doi:10.1016/j.eats.2018.08.005

Cited by 11 publications

(13 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Seo et al. 4 performed CC fixation with a dog button device and used limbs of the same suture to fix AC joint using knotless anchors. El Shewy and El Azizi 9 looped the suture tape around the coracoid and made a single drill hole in clavicle for CC fixation to reduce the complication of coracoid fracture.…”

Section: Discussionmentioning

confidence: 99%

“…Step 4 Knot-tying over the clavicle Two limbs of suture tape are tied over the clavicle for CC fixation.…”

Section: Name Of Steps Goalsmentioning

confidence: 99%

“… 1 Over the last decade, several surgical techniques have been described for the management of the AC joint dislocations. 2 , 3 , 4 The existing surgical treatment options can be divided into 2 groups: indirect repair techniques and coracoclavicular (CC) ligament reconstruction with free tendon graft. 5 Healing of CC and AC ligament in indirect repair technique is achieved by maintaining the clavicle–coracoid relationship in a reduced position for long enough to allow healing of the these ligaments.…”

mentioning

confidence: 99%

“…Seo et al. 4 described a technique of AC fixation after CC fixation with suspensory technique where a dog button was used for CC fixation, and knotless anchors were used for AC fixation. El Shewy and El Azizi 9 in their study looped the suture tape around the coracoid and made drill hole only in clavicle for CC fixation to reduce the complication of coracoid fracture.…”

mentioning

confidence: 99%

“…8 Hence, there is increased trend of both AC and CC fixation in management AC dislocations. Seo et al 4 described a technique of AC fixation after CC fixation with suspensory technique where a dog button was used for CC fixation, Steps…”

mentioning

confidence: 99%

See 4 more Smart Citations

Arthroscopy-Assisted All-Suture Coracoclavicular and Acromioclavicular Joint Stabilization in Acute Acromioclavicular Joint Injuries

Joshi

Basukala²,

Singh³

et al. 2021

Arthroscopy Techniques

View full text Add to dashboard Cite

The existing literature agrees on surgical management for Rockwood grade IV and V injuries, but there is no consensus which type of surgery is the most appropriate one. More than 150 surgeries have been described for this condition in the literature. In an injury of less than 3 weeks, most surgeons prefer suture-button devices for coracoclavicular stabilization. Recent biomechanical studies have demonstrated that coracoclavicular stabilization provides good vertical stability but poor horizontal stability of acromioclavicular joint. Hence, they recommend acromioclavicular stabilization along with coracoclavicular stabilization. The use of a suture-button device for coracoclavicular stabilization requires special implants and instruments along with high surgical skills to drill precisely placed holes in the clavicle and the coracoid in order to avoid fractures from the drill hole. Due to relatively smaller clavicle and coracoid in Asian population, making holes in the clavicle and the coracoid has increased risk of fracture. We describe a technique in which no drill holes are made in the clavicle or the coracoid. In our technique, suture tape is used, which is looped around the coracoid and the clavicle, and the limbs are tied over the clavicle to maintain the coracoclavicular distance. The remaining limbs of suture tape is further looped through the tunnels made in acromion and tied over the acromion to augment the acromioclavicular ligament. The potential advantages of this technique are no costly implant and instruments are required, avoidance of complications associated with drill holes in coracoid and clavicle, both coracoclavicular and acromioclavicular joints are stabilized, direct repair of the acromioclavicular ligament can be performed, and no need of second surgery for implant removal.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Step 4 Knot-tying over the clavicle Two limbs of suture tape are tied over the clavicle for CC fixation.…”

Section: Name Of Steps Goalsmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Arthroscopy-Assisted All-Suture Coracoclavicular and Acromioclavicular Joint Stabilization in Acute Acromioclavicular Joint Injuries

Joshi

Basukala²,

Singh³

et al. 2021

Arthroscopy Techniques

View full text Add to dashboard Cite

show abstract

Coracoid clavicular tunnel angle is related with loss of reduction in a single-tunnel coracoclavicular fixation using a dog bone button in acute acromioclavicular joint dislocation

Seo

Lee

Kim

et al. 2019

Knee Surg Sports Traumatol Arthrosc

Self Cite

View full text Add to dashboard Cite

PurposeDespite the high failure rates of techniques used to maintain the reduction of single‐tunnel coracoclavicular (CC) fixation, analyses of the etiology of loss of reduction related to surgical techniques are limited. Therefore, it was hypothesized that the initial coracoclavicular tunnel angle was related to loss of reduction in the single‐tunnel technique for AC joint dislocation. This study aimed to evaluate the clinical and radiological outcomes of arthroscopic single‐tunnel CC suture button fixation according to the initial coracoclavicular tunnel angle. MethodsThirty‐two consecutive patients who underwent arthroscopic single‐tunnel CC suture button fixation for AC joint dislocation from 2014 to 2018 were enrolled. The tunneling‐first technique was used in the first 11 patients, while the reduction‐first technique was used in the remaining 22 consecutive patients. For clinical assessments, the American Shoulder and Elbow Surgeons (ASES) score and Korean Shoulder Score (KSS) were recorded. For radiological evaluation, coracoclavicular distance ratio, coracoclavicular tunnel angle, coracoid, and clavicular tunnel widths were measured. ResultsThe ASES score did not differ significantly between the two groups (n.s.). However, the KSS was significantly better in the reduction‐first group (p = 0.031). No significant intergroup differences were observed in the pre‐ and postoperative coracoclavicular distance ratio. However, at the last follow‐up, loss of coracoclavicular distance ratio was significantly smaller in the reduction‐first group (p < 0.001). At the final follow‐up, loss of the coracoclavicular distance ratio was positively correlated with the postoperative coracoclavicular tunnel angle (p < 0.001, Spearman’s rho correlation coefficient = 0.602). The final follow‐up clavicular tunnel width was also significantly smaller in the reduction‐first group (p = 0.002). Finally, the last follow‐up clavicular tunnel width was positively correlated with the postoperative coracoclavicular tunnel angle (p = 0.008, Spearman’s rho correlation coefficient = 0.459). ConclusionThe reduction‐first technique showed better clinical and radiological outcomes than the tunneling‐first technique in single‐tunnel CC fixation for AC joint dislocation. A large postoperative coracoclavicular tunnel angle was associated with loss of reduction and clavicular tunnel widening. Therefore, obtaining a straight coracoclavicular tunnel angle is crucial for achieving better outcomes and minimizing loss of reduction. Level of evidenceIII.

show abstract

Acromioclavicular joint suture button repair leads to coracoclavicular tunnel widening

Dalos

Huber

Wichern

et al. 2022

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

Purpose Biomechanical evaluation of three different suture button devices used in acromioclavicular joint repair and analysis of their effect on post-testing tunnel widening. Methods Eighteen human shoulder girdles were assigned into three groups with a similar mean bone mineral density. Three different single-tunnel acromioclavicular repair devices were tested: (1) AC TightRope® with FiberWire; (2) AC Dog Bone™ Button with FiberTape; (3) Low Profile AC Repair System. Biomechanical testing was performed simulating the complex movement of the distal clavicle as follows. A vertical load of 80 N was applied continuously. The rotation of the clavicle about its long axis was set at 10° anterior and 30° posterior for 2500 cycles at 0.25 Hz. The horizontal translation of the clavicle was set at 6 mm medial and 6 mm lateral for 10,000 cycles at 1 Hz. The coracoclavicular distance was measured before and after testing. After testing, each sample underwent micro-CT analysis. Following 3D reconstruction, the area of the bone tunnels was measured at five defined cross sections. Results In TightRope® and Dog Bone™ groups, all samples completed testing, whereas in the Low Profile group, three out of six samples showed system failure. The mean absolute difference of coracoclavicular distance after testing was significantly greater in the Low Profile group compared to TightRope® and Dog Bone™ groups (4.3 ± 1.3 mm vs 1.9 ± 0.7 mm vs 1.9 ± 0.8 mm; p = 0.001). Micro-CT analysis of the specimens demonstrated significant tunnel widening in the inferior clavicular and superior coracoid regions in all three groups (p < 0.05). Conclusion Significant tunnel widening can be observed for all devices and is primarily found in the inferior parts of the clavicle and superior parts of the coracoid. The Low Profile AC Repair System showed inferior biomechanical properties compared to the AC TightRope® and AC Dog Bone™ devices. Therefore, clinicians should carefully select the type of acromioclavicular repair device used and need to consider tunnel widening as a complication.

show abstract

Arthroscopic Acromioclavicular Fixation With Suture Tape Augmentation After Coracoclavicular Fixation With Dog Bone Button: Surgical Technique

Cited by 11 publications

References 23 publications

Arthroscopy-Assisted All-Suture Coracoclavicular and Acromioclavicular Joint Stabilization in Acute Acromioclavicular Joint Injuries

Arthroscopy-Assisted All-Suture Coracoclavicular and Acromioclavicular Joint Stabilization in Acute Acromioclavicular Joint Injuries

Coracoid clavicular tunnel angle is related with loss of reduction in a single-tunnel coracoclavicular fixation using a dog bone button in acute acromioclavicular joint dislocation

Acromioclavicular joint suture button repair leads to coracoclavicular tunnel widening

Contact Info

Product

Resources

About