Continuous Loop Double Endobutton Reconstruction for Acromioclavicular Joint Dislocation

Struhl, Steven; Wolfson, Theodore

doi:10.1177/0363546515596409

Cited by 60 publications

(87 citation statements)

References 53 publications

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“…Some studies have demonstrated higher clinical success rates and superior biomechanical outcomes when CC ligament reconstruction has been compared with other techniques 1 - 5 . However, the detailed operative techniques, complication rates, and follow-up periods have differed among studies 6 - 13 . To our knowledge, the longest mean duration of follow-up for this procedure was 5.2 years, as reported by Struhl and Wolfson 6 .…”

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confidence: 99%

“…However, the detailed operative techniques, complication rates, and follow-up periods have differed among studies 6 - 13 . To our knowledge, the longest mean duration of follow-up for this procedure was 5.2 years, as reported by Struhl and Wolfson 6 . The long-term (>10-year) clinical and radiographic outcomes of this procedure remain uncertain 6 - 13 .…”

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confidence: 99%

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Anatomic Coracoclavicular Ligament Reconstruction for the Treatment of Acute Acromioclavicular Joint Dislocation

Daisuke¹,

Yamashita²,

Kizaki³

et al. 2017

JBJS OA

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Background:The long-term clinical and radiographic outcomes following coracoclavicular (CC) ligament reconstruction for the operative treatment of acute acromioclavicular (AC) joint dislocation remain uncertain. The purpose of the present study was to determine the long-term clinical and radiographic outcomes of CC ligament reconstruction and to identify risk factors for unfavorable outcomes.Methods:We reviewed 20 cases of AC joint dislocation in 19 patients (18 male and 1 female; mean age, 32.3 years) that were treated with single-bundle reconstruction. The mean duration of follow-up was 12.7 years. We measured the CC vertical distance (CCD) on the anteroposterior view and compared the affected and unaffected sides (CCD ratio). We divided the patients into those with a CCD ratio of <25% (Group 1) and those with a CCD ratio of ≥25% (Group 2). We radiographically investigated the clavicular tunnel anteroposterior (CTAP) angle, clavicular tunnel ratio, and coracoid tunnel orientation on the basis of the entry and exit points at the base of the coracoid. For the coracoid tunnel orientation, we compared center-center orientation and noncenter-center orientation.Results:Group 1 comprised 17 cases (85%), and Group 2 comprised 3 cases (15%). At the time of the latest follow-up, Group 1 had a significantly higher mean Constant score than Group 2 (98.2 compared with 90.7; p = 0.038). Of the 3 radiographic parameters, only the CTAP angle was significantly different between the 2 groups (p < 0.0001). Two (67%) of the 3 cases in Group 2 were associated with posterior AC joint displacement.Conclusions:CC ligament reconstruction for the treatment of acute AC joint dislocation resulted in successful long-term clinical and radiographic outcomes. It is important to decrease the CTAP angle and to ensure proper anatomic placement of the clavicular and coracoid tunnels at the time of surgery.Level of Evidence:Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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confidence: 99%

Anatomic Coracoclavicular Ligament Reconstruction for the Treatment of Acute Acromioclavicular Joint Dislocation

Daisuke¹,

Yamashita²,

Kizaki³

et al. 2017

JBJS OA

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“…Arthroscopy-assisted reconstruction of the CC ligament by endobutton fixation proved a safe and easy way for the treatment of AC joint dislocation, which can provide reliable fixation, a fast recovery and cause less trauma [8]. The continuous loop device can eliminate the possibility of knot breakage or slippage, and MRI suggested a robust healing response, which can be recommended both for chronic and acute dislocations [9]. Although the use of double endobutton plate technique for the treatment of Rockwood III-VI dislocations has been widely recognized, the improvement of the double endobutton technique has never stopped [8,9,10].…”

Section: Discussionmentioning

confidence: 99%

“…The continuous loop device can eliminate the possibility of knot breakage or slippage, and MRI suggested a robust healing response, which can be recommended both for chronic and acute dislocations [9]. Although the use of double endobutton plate technique for the treatment of Rockwood III-VI dislocations has been widely recognized, the improvement of the double endobutton technique has never stopped [8,9,10]. According to reset requirement during operation, our novel double endobutton can adjust loop length for satisfying different individual operative methods.…”

Section: Discussionmentioning

confidence: 99%

“…Since then, with the application of the double endobutton technique, postoperative complications have been significantly improved [6,7]. Although the use of double endobutton plate technique for the treatment of Rockwood III-VI dislocations has been widely recognized, the improvement of the double endobutton technique has never stopped [8,9,10].…”

Section: Introductionmentioning

confidence: 99%

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Accurate Bone Tunnel Location Based on Three-Dimensional Printing Navigation Module Technology in Coracoclavicular Ligament Reconstruction: Virtual Model vs. Real Model

Zhang

Feng

Xiong

et al. 2020

Preprint

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Background: Finding ideal bone tunnel location is key to reconstruction of the coracoclavicular (CC) ligament, which has become a fundamental surgical method for acromioclavicular (AC) joint dislocation. The study aims to explore virtual model vs. real model of accurate bone tunnel location in coracoclavicular (CC) ligament reconstruction based on 3-dimensional (3D) navigation module printing technology.Methods: Eighty human shoulders including clavicle and scapula were scanned by dual-source computed tomography (CT). CT scans of shoulder joints including clavicle and scapula were imported, the acromioclavicular joints were repositioned to form a whole model, and find the best bone tunnel through digital optimization design by Mimics 19.0 software. In Geomagic Studio software, forming the clavicle navigation module, which was generated for 3D printing. Then 10 parameters of a real bone tunnel and virtual bone tunnel can be measured and compared.Results: Eighty human shoulders including clavicle and scapula were designed and printed successfully. Then 10 parameters of the real and virtual bone tunnels were recorded and compared. No difference was significantly found between the real and virtual bone tunnels in 10 measurements (p>0.05).Conclusions: The accuracy of bone tunnel location for CC reconstruction in adult shoulders based on 3D printing navigation module technology is reliable.

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Arthroscopy‐assisted procedure provides less residual horizontal instability and optimal coracoid tunnel creation with less radiation exposure compared to percutaneous procedure after endo‐button fixation of type III AC joint dislocations

İğrek,

Şahbat,

Yiğit

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeThe aim of this study was to evaluate the postoperative radiological and functional results of patients treated with arthroscopy‐assisted (AA) and percutaneous (P) procedures using endo‐button for type III acromioclavicular joint dislocations with a minimum 1‐year follow‐up. The study hypothesis was that the AA technique would provide more favourable coracoid tunnels.MethodsThis retrospective study included patients who underwent surgery between 2017 and 2022. Computed tomography images taken immediately postoperatively of all the patients were analysed to group coracoid tunnels as optimal or suboptimal based on orientation and placement within the coracoid base. Residual horizontal instability was assessed using the bilateral Alexander view at the final follow‐up. Shoulder functions were evaluated at the final follow‐up examination.ResultsOf the 63 patients, 39 underwent surgery using the percutaneous procedure and 24 with the AA procedure. Surgical duration was significantly longer in the AA group (AA: 61.1 ± 5.9 min; P: 34.7 ± 5.6 min) (p = 0.001; 95% confidence interval [CI]: 23.3–29.3), whereas fluoroscopy time was longer in the percutaneous group (AA: 2.0 ± 0.8 s; P: 15.7 ± 3.9 s) (p = 0.001; 95% CI: −14.9 to 12.3). Optimal coracoid tunnels were more frequently observed in the AA group (p = 0.001; 95% CI: 7.4−137.8). There was no significant difference in functional scores between the groups (n.s.). Postoperative horizontal instability was more common in the percutaneous procedure (p = 0.013; 95% CI: 8.3–39.2).ConclusionsAlthough no difference was detected between the methods in terms of complications and functional results, the higher frequency of residual horizontal instability, the high risk of suboptimal tunnel creation and greater radiation exposure were seen to be the most important disadvantages of the percutaneous technique. During surgery, such technical problems related to the percutaneous method should be kept in mind and care should be taken about the orientation of the coracoid tunnel.Level of EvidenceLevel III.

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Continuous Loop Double Endobutton Reconstruction for Acromioclavicular Joint Dislocation

Abstract: Background: Current anatomic methods for reconstruction of the dislocated acromioclavicular (AC) joint show improved clinical results but continue to be associated with significant rates of fixation loss and complications, limiting more widespread use.

Cited by 60 publications

References 53 publications

Anatomic Coracoclavicular Ligament Reconstruction for the Treatment of Acute Acromioclavicular Joint Dislocation

Anatomic Coracoclavicular Ligament Reconstruction for the Treatment of Acute Acromioclavicular Joint Dislocation

Accurate Bone Tunnel Location Based on Three-Dimensional Printing Navigation Module Technology in Coracoclavicular Ligament Reconstruction: Virtual Model vs. Real Model

Arthroscopy‐assisted procedure provides less residual horizontal instability and optimal coracoid tunnel creation with less radiation exposure compared to percutaneous procedure after endo‐button fixation of type III AC joint dislocations

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