Arthroscopic acromioclavicular joint reconstruction using a synthetic ligament device

Abstract

Purpose To describe an all-arthroscopic treatment of acromioclavicular joint (ACJ) dislocation and report the clinical results of the procedure. Methods This study consisted of 54 patients of whom 49 were men and 5 were women. The age of the patients averaged 39 years (range 16-69 years). All the symptomatic acute and chronic acromioclavicular joint dislocations classified according to Rockwood type III-IV were included in the study. All of them underwent standard clinical and radiological examination. Result All the patients were regularly followed up at the institute with the average follow-up being 15.09 months (range 5-30 months). The results were assessed using the shoulder subjective value (SSV) and the Modified rating of the University of California Los Angeles (UCLA) for acromioclavicular joint. The mean pre-operative SSV improved from 35.65 to the post-operative value of 88.6. According to the UCLA scale, 40 excellent, 8 good, 4 fair and 2 poor results were achieved. There were few problems encountered with the procedure like failure of ligament, incomplete reduction, capsulitis, and migration of sleeve and fracture clavicle.Conclusion ACJ dislocations can effectively be treated with arthroscopy-assisted procedure. Since this procedure has given uniformly good to excellent results comparable to open reconstructive procedures, it can be a good treatment option for symptomatic ACJ dislocations. Level of evidence IV, therapeutic series.

Complications following arthroscopic fixation of acromioclavicular separations: a systematic review of the literature

“…Eleven articles reported residual shoulder, hardware irritation, or ACJ pain as a postoperative complication with a pooled rate of 26.7% (95% CI: 17.8%–36.6%; I 2 =57.2%) ( Figure 3 ). Kany et al 20 reported six patients who experienced postoperative capsulitis and night pain. Each of these cases ultimately resolved with medical management.…”

“… 10 Furthermore, there have been multiple reports of significant complication rates using arthroscopic or arthroscopically assisted techniques including: hardware erosion into the clavicle in over 40% of cases; 19 hardware failures in 70% of cases; 10 and, less commonly, persistent pain, infection, clavicle or coracoid fracture, CC calcification, and shoulder stiffness. 20 , 21 …”

Acromioclavicular joint injuries: diagnosis, classification and ligamentoplasty procedures

“…However, the proximity of some important neurovascular structures, particularly the suprascapular nerve and the suprascapular artery, must always be remembered. On the other hand, there are also other less frequent complications, such as infection, that are usually superficial, post-operative capsulitis and pain, particularly night pain, 37 irritation over the superior aspect of the implant and CC calcification.…”

Comparison of the outcome of early and delayed surgical treatment of complete acromioclavicular joint dislocation

“…The same surgical technique is used for early and delayed surgery in four studies [9,10,19,23]. These four surgical techniques include hook plate technique, coraco-clavicular (CC) reconstruction with lArS, Dewar-Barrington …”