Arthroscopic-Assisted Double-Bundle Coracoclavicular Ligament Reconstruction Using Cortical Fixation Buttons With Suture Tape Provides Superior Vertical Stability Than the Single-Bundle Reconstruction for Acute Acromioclavicular Joint Dislocation

Park, In; Lee, Sanghyeon; Shin, Sang-Jin

doi:10.1016/j.arthro.2022.09.018

Cited by 7 publications

(6 citation statements)

References 23 publications

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“…The CMS of 45 patients with Type 3 and higher ACJ dislocation operated with single‐bundle SLD with a mean follow‐up of 4.8 years was 83.7 19 . On the other hand, double‐bundle SLD provides better vertical stability compared to single‐bundle 20 . In the current study, a single‐bundle SLD was used, the CMS for all patients was 89.3 after a mean follow‐up of 22.3 months.…”

Section: Discussionmentioning

confidence: 85%

“… 19 On the other hand, double‐bundle SLD provides better vertical stability compared to single‐bundle. 20 In the current study, a single‐bundle SLD was used, the CMS for all patients was 89.3 after a mean follow‐up of 22.3 months.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of reduction loss was found to be 24% in patients operated on with the mini‐open technique using a single‐bundle SLD and 25% in patients who underwent arthroscopic surgery 10,11 . In addition, reduction loss rates were 33.0% and 3.2% in patients operated on with single and double‐bundle SLD, respectively 9,20 . The definition of “reduction loss” is not clear in the literature.…”

Section: Discussionmentioning

confidence: 99%

“…Çarkçı et al reported a mean CMS of 92.03 after a mean follow‐up of 31 months in 36 patients who underwent arthroscopic surgery with a single‐bundle SLD 10 . Additionally, CMS scores of 92.9 and 94.8 were achieved in patients operated with single‐ and double‐bundle SLD, respectively 20 . In a study comparing single‐bundle SLD with open and arthroscopic surgery, CMS was found 84.45 and 84.18 at the last follow‐up, respectively 8 .…”

Section: Discussionmentioning

confidence: 99%

“… 10 , 11 In addition, reduction loss rates were 33.0% and 3.2% in patients operated on with single and double‐bundle SLD, respectively. 9 , 20 The definition of “reduction loss” is not clear in the literature. In some studies, the change in the CC distance measured at the last follow‐up in millimeters compared to postoperative day 1 is accepted as “reduction loss”, whereas in some studies, a change of more than 50% in this distance is accepted as “reduction loss”.…”

Section: Discussionmentioning

confidence: 99%

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The Effect of Clavicular Tunnel Position on Reduction Loss in Patients with Acute Acromioclavicular Joint Dislocations Operated with a Single‐Bundle Suspensory Loop Device

Senel,

Eren,

Batur

et al. 2024

Orthopaedic Surgery

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ObjectiveThe treatment of acromioclavicular joint (ACJ) dislocations offers numerous options, and ongoing debates persist regarding their comparative effectiveness. Among these options, the suspensory loop device (SLD) is one of the most favored treatment modalities. Despite the observed high reduction loss rate associated with SLD, the treatment yields favorable clinical outcomes. This study aimed to investigate the clinical outcomes of patients with acute type 3 and 5 ACJ dislocations who underwent open and arthroscopic procedures using a single‐bundle SLD, and to evaluate the effect of clavicular tunnel position on reduction loss.MethodsThirty‐seven eligible patients diagnosed with acute type 3 and type 5 ACJ dislocation who underwent open and arthroscopic surgery with a single‐bundle SLD between January 2015 and March 2022 were evaluated retrospectively. Demographic data and radiological measurements including coracoclavicular (CC) interval, clavicle length (CL), and implant distance (ID) were recorded. The ID/CL ratio was calculated and a value between 0.17 and 0.24 was considered as “acceptable implant position”. Reduction loss and other complications were noted. Patients were divided into two groups: open (Group 1) and arthroscopic (Group 2). Constant Murray Score (CMS) and Visual Analog Scale (VAS) were used for clinical and functional outcomes. Non‐parametric tests were used for statistical analysis of variables.ResultsThe study included six females (16.2%) and 31 males (83.8%) with a mean age of 40.2 ± 14.7 years (range: 20–75). The mean follow‐up period was 22.3 ± 16.7 months (range: 6–72). The average time from trauma to surgery was 6.3 ± 5.3 days (range: 1–18). At the last follow‐up, the CMS was 89.3 ± 8.8 and the VAS score was 2.1 ± 0.9. The mean ID/CL ratio was 0.19 ± 0.1 and 19 patients (51.4%) were between 0.17 and 0.24. Reduction loss was observed in nine patients (24.3%). There were no significant differences between Group 1 and Group 2 regarding operation time (p = 0.998), ID/CL ratio (p = 0.442), reduction loss (p = 0.458), CMS (p = 0.325), and VAS score (p = 0.699). Of the 28 patients without reduction loss, 16 had an ID/CL ratio between 0.17 and 0.24 (p = 0.43). Furthermore, within the 0.17–0.24 interval, CMS was higher with an average of 91.8 ± 5.1 compared to the other intervals (p = 0.559).ConclusionThe clinical and functional outcomes of acute type 3 and type 5 ACJ dislocation operated open and arthroscopically with single‐bundle SLD are similar and satisfactory. A clavicular tunnel position in the range of 0.17–0.24 (ID/CL ratio) is recommended to maintain postoperative reduction.

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Section: Discussionmentioning

confidence: 85%

Section: Discussionmentioning

confidence: 99%