Complication rates and types of failure after arthroscopic acute acromioclavicular dislocation fixation. Prospective multicenter study of 116 cases

Abstract

Level of evidence 4.

Primary Acromioclavicular-Coracoclavicular Reconstruction Using 2 Allografts, TightRope, and Stabilization to the Acromion

“…Numerous modifications of the Weaver-Dunn technique and anatomic CC reconstruction have been reported including both open and arthroscopic options 7, 8, 9, 12, 13. Despite these efforts, up to 80% of patients following AC reconstruction have been reported to lose radiographic reduction, and between 20% and 30% of patients treated surgically are reported to have complications leading to reoperation 14, 15. The goal of the presented technique is to use the biomechanical data available to create a construct that minimizes failure and provides anatomic restoration of the AC joint using a reinforced biologic construct.…”

Arthroscopic Acromioclavicular Joint Reconstruction Using Knotless Coracoclavicular Fixation and Soft-Tissue Anatomic Coracoclavicular Ligament Reconstruction

“…12 Minimally invasive anatomic reconstruction of the AC joint is technically challenging, with complication rates of 27% to 44% reported with initial surgical techniques. 5 Complications including fractures of the clavicle or coracoid process, loss of reduction, implant failure with suture rupture, caudal migration of the supraclavicular implants, and local soft-tissue pain due to hardware or suture irritation have led to a continuous development of arthroscopically assisted techniques and implants.…”

“…12 A recent systematic review of arthroscopically assisted techniques found an overall rate of hardware irritation of 26.7%. 11 Cases of revision surgery with implant and suture removal have been described.…”

“…14 Postoperative loss of reduction has been reported with most surgical techniques of AC joint reconstruction ever since their introduction. 6,12 Many authors advocate the use of suture-button devices only for the stabilization of acute AC joint injuries and the use of soft-tissue graft techniques for chronic cases.…”

“…9 Despite the advantage of single bone tunnels with a lower fracture risk, these newer techniques had the disadvantage of having a thicker knot stack on top of the clavicle. 11,12 In a systematic review assessing the rates of complications of AC joint procedures, Woodmass et al 11 identified hardware irritation as the most common source of postoperative pain, with 4 studies using a suture-button fixation technique reporting the rate of this complication as 25% or greater.…”