Comparison of Short-term Complications Between 2 Methods of Coracoclavicular Ligament Reconstruction

Rush, Lane; Lake, Nicholas; Stiefel, E; Hobgood, E. Rhett; Ramsey, J. Randall; O’Brien, Michael J.; Field, Larry D.; Savoie, Felix H.

doi:10.1177/2325967116658419

Cited by 25 publications

(28 citation statements)

References 30 publications

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“…Patients with complications have significantly lower clinical scores, suggesting that the presence of complications appears to be the only predictor of poorer clinical outcomes[ 13 , 14 , 35 , 71 ]. Complications after surgical treatment range from 27% to 44%[ 13 , 28 ]; the main being infection (4% to 8%), hardware complications (4%) and further surgery (13%)[ 68 ].…”

Section: Complicationsmentioning

confidence: 99%

New insights in the treatment of acromioclavicular separation

Bergen¹,

Bemmel²,

Alta³

et al. 2017

WJO

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A direct force on the superior aspect of the shoulder may cause acromioclavicular (AC) dislocation or separation. Severe dislocations can lead to chronic impairment, especially in the athlete and high-demand manual laborer. The dislocation is classified according to Rockwood. Types I and II are treated nonoperatively, while types IV, V and VI are generally treated operatively. Controversy exists regarding the optimal treatment of type III dislocations in the high-demand patient. Recent evidence suggests that these should be treated nonoperatively initially. Classic surgical techniques were associated with high complication rates, including recurrent dislocations and hardware breakage. In recent years, many new techniques have been introduced in order to improve the outcomes. Arthroscopic reconstruction or repair techniques have promising short-term results. This article aims to provide a current concepts review on the treatment of AC dislocations with emphasis on recent developments.

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Section: Complicationsmentioning

confidence: 99%

New insights in the treatment of acromioclavicular separation

Bergen¹,

Bemmel²,

Alta³

et al. 2017

WJO

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“…At the radiological evaluation, AC degeneration was observed in 4 patients (13.3%). According to criteria of Rush et al, 14 2 cases (6.6%) showed loss of reduction in the AP incidence, and 4 cases (13.3%), in the Zanca incidence. Residual subluxations were observed in 24 patients (80%) in the AP incidence, and in 20 patients (67%) in the Zanca incidence.…”

Section: Resultsmentioning

confidence: 94%

“…13 The radiological evaluation also used a ratio as a comparative measure of the CC distance (CCd) of the operated and normal sides (CCd_O/N), in the radiograph of the clavicle in the AP and Zanca incidences, dividing the value of the CCd of the operated side (CCd_O) by the one of the normal side (CCd_N), as demonstrated in Figure 1 . We also adopted the radiological criteria according to Rush et al 14 for the assessment of the postoperative AC reduction, considering loss of postoperative reduction an increase in CCd_O/N ≥ 2, and residual subluxation as CCd_O/N between 1 and 2.…”

Section: Methodsmentioning

confidence: 99%

Resultados funcionais e radiológicos do tratamento cirúrgico da luxação acromioclavicular aguda com âncoras e fixação clavículo-escapular

et al. 2019

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Objective To evaluate the clinical, radiological and functional results of the surgical treatment of acute acromioclavicular dislocation using a coracoclavicular fixation technique (syndesmopexy) with two metallic anchors, temporary clavicle and scapula fixation, and transfer of the coracoacromial ligament. Methods Longitudinal observational study of 30 patients with diagnoses of acute acromioclavicular dislocation, who were submitted to surgical treatment with a minimum follow-up of six months, and who were evaluated clinically, radiologically, and by the University of California at Los Angeles (UCLA), the Disabilities of the Arm, Shoulder and Hand (DASH) and the Constant-Murley functional scores. Results The mean values of the scores were: UCLA = 32; DASH = 11.21; and Constant-Murley = 86.93, with satisfactory results higher than 80%. The unsatisfactory results were associated with acromioclavicular pain on palpation, positive subacromial impingement tests, and older age group, presenting statistical significance ( p < 0.05). Radiologically, higher values on account of the coracoclavicular distance ratio from the operated shoulder compared to the normal shoulder were related to worse outcomes, but with no statistically significant difference. No associations were found between the results of the functional scores and the variables degree of the injury, coracoacromial ligament transfer, clinical impression of loss of reduction and scapulothoracic dyskinesis. Conclusion The technique used provides an efficient fixation, with a high level of satisfaction according to the UCLA, Constant-Murley and DASH scores; moreover, it has a low complication rate, despite the high rate of residual radiological acromioclavicular subluxation.

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“…It has been proved that after the coracoclavicular ligament reconstruction, one of the complications is loss of reduction [1,14]. Such loss of compression may result from the rupture of sutures on the KS [8,15]. Surgeons should take into consideration the fact that during the time in internal medium, sutures may lose their initial TS and take precautionary measures to avoid that.…”

Section: Discussionmentioning

confidence: 99%

“…One of the most common complications after AC joint stabilization surgery is the loss of reduction [6]. Recently published papers reveal the main risk factors such as wrong clavicle tunnel location, button migration, osteoporosis and suture breakage for this complication to occur [7][8]. We predict that an in vivo environment may affect polyester suture's material and cause its physical properties to become worse leading to loss of reduction.…”

Section: Introductionmentioning

confidence: 97%