Avaliação dos ligamentos acromioclavicular, coracoclaviculares e coracoclavicular medial na luxação acromioclavicular

Filho, Rômulo Brasil; Freitas, Marcelo Mamede de; Nunes, Rafael Henrique Rangel; Junior, Antonio Carlos Tenor; Costa, Miguel Pereira da; Roberto, Rodrigo de Araújo

doi:10.1055/s-0040-1719088

Cited by 5 publications

(4 citation statements)

References 11 publications

(15 reference statements)

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“…In this regard, the findings of this review support the notion that there are a variety of surgical techniques available for the surgical treatment of acromioclavicular displacement [1]. Because of the number of options and structures involved [26], each procedure retains its competencies, domains and problems [27] [28].…”

Section: Discussionsupporting

confidence: 58%

Comparison of Surgical Techniques Used in Treating Acromioclavicular Dislocation in Patients Participating in Sports: A Systematic Review

Nascimento,

Cunha,

Abreu

et al. 2024

OJO

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Introduction:The acromioclavicular joint is a superficial diarthrodial joint that surrounds the medial articular facet of the acromion and the distal portion of the clavicle. Due to its anatomy and biomechanics, it is highly susceptible to trauma and in young men who play contact sports, acromioclavicular dislocation is common. This article aimed to systematically review the literature and compare the surgical techniques used in the treatment of acromioclavicular dislocation in patients who practice sports. Methods: This systematic review was conducted according to the International Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Eligible studies for this systematic review included articles in English or Spanish published between 2013 and 2023, which mention the occurrence of acromioclavicular dislocation during sports practices. Additionally, only studies that addressed the surgical treatment of acromion-clavicular dislocation and contained original data on the topic were included. Results: We found 144 eligible studies after searching the LILACS and PubMed databases. Based on the inclusion and exclusion criteria and the reviewers' consensus, we selected four studies for the systematic review. 133 patients with AC joint displacement were evaluated. Mean Age: approximately 31.90 years. 81.92 of these injuries occurred during sports practice.

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Section: Discussionsupporting

confidence: 58%

Comparison of Surgical Techniques Used in Treating Acromioclavicular Dislocation in Patients Participating in Sports: A Systematic Review

Nascimento,

Cunha,

Abreu

et al. 2024

OJO

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“…To date, dynamic AC joint distance has only been investigated by a few studies, which primarily focused on the AC distance or space with the arm relaxed. 8,16,19,37,44 Filho et al 8 dissected the AC joint capsule and measured the AC distance without active muscle contractions. Jensen et al 16 reported the average AC distance (4.9 mm) on the uninjured side of patients with AC joint reconstruction by ultrasound; however, only 1 frontal plane of the AC joint was used for measurements, by which the minimum distance between the acromion and the clavicle was unable to be obtained.…”

Section: Discussionmentioning

confidence: 99%

In Vivo Analysis of Acromioclavicular Kinematics and Distance During Multiplanar Humeral Elevation

Zhu,

Chen,

Wang

et al. 2024

Am J Sports Med

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Background: Knowledge of acromioclavicular (AC) joint kinematics and distance may provide insight into the biomechanical function and development of new treatment methods. However, accurate data on in vivo AC kinematics and distance between the clavicle and acromion remain unknown. Purpose/Hypothesis: The purpose of this study was to investigate 3-dimensional AC kinematics and distance during arm elevation in abduction, scaption, and forward flexion in a healthy population. It was hypothesized that AC kinematics and distance would vary with the elevation angle and plane of the arm. Study Design: Controlled laboratory study. Methods: A total of 19 shoulders of healthy participants were enrolled. AC kinematics and distance were investigated with a combined dual fluoroscopic imaging system and computed tomography. Rotation and translation of the AC joint were calculated. The AC distance was measured as the minimum distance between the medial border of the acromion and the articular surface of the distal clavicle (ASDC). The minimum distance point (MDP) ratio was defined as the length between the MDP and the posterior edge of the ASDC divided by the anterior-posterior length of the ASDC. AC kinematics and distance between different elevation planes and angles were compared. Results: Progressive internal rotation, upward rotation, and posterior tilt of the AC joint were observed in all elevation planes. The scapula rotated more upward relative to the clavicle in abduction than in scaption ( P = .002) and flexion ( P = .005). The arm elevation angle significantly affected translation of the AC joint. The acromion translated more laterally and more posteriorly in scaption than in abduction ( P < .001). The AC distance decreased from the initial position to 75° in all planes and was significantly greater in flexion ( P < .001). The MDP ratio significantly increased with the elevation angle ( P < .001). Conclusion: Progressive rotation and significant translation of the AC joint were observed in different elevation planes. The AC distance decreased with the elevation angle from the initial position to 75°. The minimum distance between the ASDC and the medial border of the acromion moved anteriorly as the shoulder elevation angle increased. Clinical Relevance: These results could serve as benchmark data for future studies aiming to improve the surgical treatment of AC joint abnormalities to restore optimal function.

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“…11 CC ligament reconstruction is currently recommended for ACJ dislocation because the CC ligament plays a crucial role in the physiological function of the ACJ. 12,13 CC stabilization using Endobuttons placed either via open surgery or arthroscopically reportedly achieves good clinical and radiological outcomes. 14,15 However, the difficult part of the Endobutton technique for CC stabilization was placement of the Endobutton at the coracoid base, 16 which often required repeated attempts.…”

Section: Introductionmentioning

confidence: 94%

“…However, each surgical technique has advantages and disadvantages, and there is no consensus regarding the “gold standard” of fixation for acute Rockwood type III ACJ dislocation 11 . CC ligament reconstruction is currently recommended for ACJ dislocation because the CC ligament plays a crucial role in the physiological function of the ACJ 12,13 . CC stabilization using Endobuttons placed either via open surgery or arthroscopically reportedly achieves good clinical and radiological outcomes 14,15 .…”

Section: Introductionmentioning

confidence: 99%

A Self‐Designed Endobutton Installation Device for Coracoclavicular Stabilization in Acute Rockwood Type III Acromioclavicular Joint Dislocation

Jie,

Yang,

Xiang

2024

Orthopaedic Surgery

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ObjectiveEndobutton technique could provide flexible coracoclavicular (CC) stabilization for acromioclavicular joint (ACJ) dislocation and achieved good clinical outcomes. However, the difficult part of this technique was placement of the Endobutton to the coracoid base. In this study, we designed an Endobutton installation device to place the Endobutton at the coracoid base. And we examined the clinical and radiographic outcomes of patients with acute Rockwood type III ACJ dislocation repaired with Endobutton using this device.MethodsWe designed an Endobutton installation device to place the Endobutton at the coracoid base to achieve CC stabilization. We retrospectively reviewed 42 patients with acute Rockwood type III ACJ dislocation who underwent CC stabilization with Endobuttons placed either using this novel device (group I, n = 19) or the traditional technique (CC stabilization without using special device, group II, n = 23) from January 2015 to April 2020. The two groups were compared regarding the operative time, intraoperative blood loss, and clinical and radiologic outcomes at final follow‐up. The operation‐related complications were also evaluated. The Student's t test and the Mann–Whitney U‐test were used to compare differences in continuous variables. Differences in categorical variables were assessed with either the Pearson's chi‐squared test or Fisher's exact test.ResultsForty‐two patients were clinically followed up for a minimum of 12 months. Compared with group II, group I had a significantly shorter mean operative time (56.05 ± 7.82 min vs. 65.87 ± 7.43 min, p < 0.01) and significantly lesser mean intraoperative blood loss (67.89 ± 14.75 mL vs. 94.78 ± 25.01 mL, p < 0.01). At final follow‐up, there were no significant differences between the two groups in the visual analog scale score for pain, Oxford Shoulder Score, Disabilities of the Arm, Shoulder, and Hand score, and postoperative CC distance of the affected side. Loss of reduction occurred in four patients in group I and three patients in group II (p = 0.68); there were no other operation‐related complications in either group.ConclusionsThe Endobutton installation device makes placement of the Endobutton at the coracoid base easier and achieves satisfactory clinical and radiologic outcomes without additional complications in acute Rockwood type III ACJ dislocation.

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Avaliação dos ligamentos acromioclavicular, coracoclaviculares e coracoclavicular medial na luxação acromioclavicular

Cited by 5 publications

References 11 publications

Comparison of Surgical Techniques Used in Treating Acromioclavicular Dislocation in Patients Participating in Sports: A Systematic Review

Comparison of Surgical Techniques Used in Treating Acromioclavicular Dislocation in Patients Participating in Sports: A Systematic Review

In Vivo Analysis of Acromioclavicular Kinematics and Distance During Multiplanar Humeral Elevation

A Self‐Designed Endobutton Installation Device for Coracoclavicular Stabilization in Acute Rockwood Type III Acromioclavicular Joint Dislocation

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