Complications After Anatomic Fixation and Reconstruction of the Coracoclavicular Ligaments

Abstract

Anatomic procedures to treat disrupted CC ligaments using either CFBs or TGs resulted in an overall complication rate of 27.1% (16/59). Construct survivorship was calculated to be 86.2% at 12 months and 83.2% at 24 months. Good to excellent outcomes could only be reported in those patients who did not have a complication.

Managing and recognizing complications after treatment of acromioclavicular joint repair or reconstruction

“…There is even less evidence available to dictate the best strategy for revision following failed AC joint [18]. In their series, the overall construct survivorship without complications was 86 and 83 % at 12 and 24 months, respectively [18].…”

Arthroscopically Assisted Anatomic Coracoclavicular Ligament Reconstruction Technique Using Coracoclavicular Fixation and Soft-Tissue Grafts

“…Good to excellent clinical results have been reported after reconstruction of the coracoclavicular ligaments with soft-tissue grafts 10 ; however, complications including graft rupture, hardware failure, and fracture of the clavicle or coracoid through bone tunnels are a concern. 4 A study conducted by Spiegl et al 7 showed a significant decrease in clavicle strength when bone tunnels were created for graft passage. However, using a single 3-mm bone tunnel placed through the distal clavicle and the coracoid base did not result in a change in clavicular load to failure when compared with the intact state.…”

“…The ideal management of grade III injuries remains controversial, with many surgeons performing surgery acutely in highlevel athletes and manual laborers. [3][4][5] The original Weaver-Dunn method of AC joint reconstruction has been modified over the past 4 decades, most recently with anatomic coracoclavicular ligament reconstruction with soft-tissue grafts, which have shown superiority on biomechanical testing. 6 Bone tunnels through the clavicle are commonly used to reconstruct the coracoclavicular ligaments; however, they have been associated with a significant decrease in clavicle strength with a subsequent increase in the risk for postoperative fracture.…”

Hakenplatte noch Standard bei Akromioklavikulargelenksprengung?

“…Erwähnenswert ist zudem, dass bei dem arthroskopisch assistierten Verfahren mit "tight rope" die Nachbehandlung im Allgemeinen sehr restriktiv gehandhabt wird. Hier wird von den Operateuren eine 6-wöchige Ruhigstellung in der Schlinge mit nur passiver Beweglichkeit empfohlen [11,17]. Im Gegensatz hierzu erlaubt die Versorgung mit Hakenplatte eine relativ rasche freie Beweglichkeit.…”