Evaluation of the Acromioclavicular Joint Morphology for Minimizing Subacromial Erosion after Surgical Fixation of the Joint Using a Clavicular Hook Plate

Kim, Sung Jae; Kee, Young Moon; Park, Dong-Hyuck; Ko, Young-Hwan; Lee, Bong Gun

doi:10.5397/cise.2018.21.3.138

Cited by 8 publications

(8 citation statements)

References 20 publications

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“…With this definition, they measured an inclination of 17.1° ± 10.5°, which is confirmed by our data. 19 Yoon et al performed a CT-based analysis of 46 patients. They called the inclination ‘distal clavicle-acromion angle’ which was noted with a mean of 24.6° ± 6.8°.…”

Section: Discussionmentioning

confidence: 99%

Three-dimensional morphometric analysis of the lateral clavicle and acromion: Implications for surgical treatment using subacromial support

Zenker¹,

Shamsollahi²,

Galm³

et al. 2022

SAGE Open Medicine

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Objectives: Dislocations and periarticular fractures of the acromioclavicular joint are common injuries of the shoulder girdle. When surgical intervention is indicated, subacromial support is one option to restore the alignment between scapula and the distal/lateral clavicle. Devices used for subacromial support rely on a form of subacromial ‘hook’. The shape, inclination and orientation of which is often mismatched to the anatomy of the inferior surface of the acromion, which may lead to painful acromial osteolysis and rotator cuff abrasion causing impingement. The primary goal of this study was to characterize the geometrical parameters of the acromion and distal clavicle, and their orientation at the acromioclavicular joint. Methods: Computed tomography scans of 120 shoulders were converted into digital three-dimensional models. Measurements of the acromion inclination and acromion width relative to the torsional angle as well as the clavicle depth were taken. A numerical optimization of the anatomical parameters (including torsional and inclination angles, height and width) was performed to find the combination of those parameters with the lowest interpatient variability. Results: The mean clavicle depth was found to be 11.1 mm. The mean acromion width was 27 mm. The combination of torsional and inclination angles with lowest interpatient variability was found at 80° and 16°, respectively. Conclusion: There is a high interpatient variability in the morphology of the inferior surface of the acromion. Subacromial support using a ‘hook’ can be optimized for contact surface area, which should lead to fewer complications after the restoration of acromioclavicular orientation using acromial support strategies.

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Section: Discussionmentioning

confidence: 99%

Three-dimensional morphometric analysis of the lateral clavicle and acromion: Implications for surgical treatment using subacromial support

Zenker¹,

Shamsollahi²,

Galm³

et al. 2022

SAGE Open Medicine

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“…This FEA of the biomechanical impact of a clavicle hook plate with different posterior hook offsets fixed at various acromion positions provides the basis for a new-design clavicle hook plate, as well as a clearer understanding of the posterior hook offset design of the clavicle hook plate. It is anticipated that clavicle hook plates specific to each patient can be used to get better stress and reaction force distributions on the acromioclavicular joint [10,19,[23][24][25]29]. The research on the hook plate with posterior hook offset involves not only the biomechanical effect but also the patient's subjective feeling with different hook offset implantations.…”

Section: Discussionmentioning

confidence: 99%

“…Although it is a convenient, simple, and effective treatment [5,6], some complications still occur, such as subacromial osteolysis [8][9][10], rotator cuff impingement [11], rotator cuff tear [11], and peri-implant fracture [10,[12][13][14][15]. Furthermore, there is much variation in the anatomy of the acromion between individuals [16][17][18][19]. Nonetheless, biomechanical analysis has revealed many design parameters of the clavicle hook plate [20][21][22], and therefore, if an individualized clavicle hook plate designed for the patient's anatomy can be implanted, postoperative complications may be reduced [19,[23][24][25].…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, there is much variation in the anatomy of the acromion between individuals [16][17][18][19]. Nonetheless, biomechanical analysis has revealed many design parameters of the clavicle hook plate [20][21][22], and therefore, if an individualized clavicle hook plate designed for the patient's anatomy can be implanted, postoperative complications may be reduced [19,[23][24][25].…”

Section: Introductionmentioning

confidence: 99%

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Biomechanical Analysis of Clavicle Hook Plates with a Range of Posterior Hook Offsets Implanted at Different Acromion Positions in the Acromioclavicular Joint: A Finite Element Analysis Study

Hung

Lee

2021

Applied Sciences

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The clavicle hook plate is commonly used in acromioclavicular injuries; however, the biomechanical effect of the posterior hook offset and hook position is unclear. This study applied a finite element analysis (FEA) to evaluate these parameters to improve the clinical strategy. Nine FEA models with 0-mm, 5-mm, and 10-mm posterior hook offsets implanted in the anterior, middle, and posterior acromion were established to evaluate the stress distribution and the reaction force on the acromion. The 5-mm and 10-mm posterior hook offsets at all acromion positions reduced the reaction force on the acromion but slightly increased the stress on the clavicle. The 0-mm offset increased the reaction force at all acromion positions and was relatively lower at the middle acromion. The clavicle hook plate with a posterior hook offset reduces the reaction force on the acromion, providing a flexibility of the hook position. These results provide surgeons with the biomechanical basis for the hook offset and position and engineers with the mechanical basis for the implant design.

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“…Some studies have evaluated the contact characteristics between the acromion and hook plate. These studies concluded that the pinpoint between the hook plate tip and the under surface of the acromion is the main factor inducing subacromial erosion [ 14 , 30 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of subacromial erosion shape on rotator cuff and clinical outcomes after hook plate fixation in type 5 acromioclavicular joint dislocations: a retrospective cohort study

Kim

Hyun

et al. 2022

BMC Musculoskelet Disord

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Background Surgical fixation using hook plates is widely used in the treatment of acromioclavicular (AC) joint dislocations. The purpose of this study was to evaluate the incidence and shape of subacromial erosions after removal of the hook plate in type 5 AC joint dislocations. Further, we evaluated the effect of the shape of the subacromial erosion on the rotator cuff. Methods We retrospectively reviewed 30 patients who underwent hook plate fixation for type 5 AC joint dislocations at our hospital between December 2010 and December 2018. Patients with a follow-up of at least 1 year were included. Clinical outcomes were assessed using the final follow-up Constant-Murley, Korean Shoulder, and visual analog scores. To ensure that the appropriate reduction was well maintained, the coracoclavicular distances of the injured and contralateral sides were evaluated at the last follow-up. Computed tomography was performed to investigate the presence and shape of the subacromial erosion after hook plate removal at 4 months after surgery. Ultrasonography was performed to investigate the presence of rotator cuff lesions at the last follow-up. Clinical and radiological outcomes were compared between groups divided according to the presence and types of subacromial erosions. Results Subacromial erosion was observed in 60% of patients (18/30): 13, 2, and 3 simple groove, cave, and marginal protrusion types, respectively. Four patients showed reduction loss at the final follow-up. There were no significant differences in clinical and radiological outcomes between the groups with and without subacromial erosion. Moreover, there were no significant differences between groups according to the types of subacromial erosion. There were no rotator cuff lesions, such as partial tears, in the injured shoulders. Conclusions Hook plate fixation may induce subacromial erosions. However, the subacromial erosions caused by the hook plate did not affect the clinical outcomes of type 5 AC joint dislocations. Moreover, regardless of its shape, the subacromial erosion did not affect the clinical outcomes nor cause rotator cuff lesions after plate removal.

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Evaluation of the Acromioclavicular Joint Morphology for Minimizing Subacromial Erosion after Surgical Fixation of the Joint Using a Clavicular Hook Plate

Cited by 8 publications

References 20 publications

Three-dimensional morphometric analysis of the lateral clavicle and acromion: Implications for surgical treatment using subacromial support

Three-dimensional morphometric analysis of the lateral clavicle and acromion: Implications for surgical treatment using subacromial support

Biomechanical Analysis of Clavicle Hook Plates with a Range of Posterior Hook Offsets Implanted at Different Acromion Positions in the Acromioclavicular Joint: A Finite Element Analysis Study

Effect of subacromial erosion shape on rotator cuff and clinical outcomes after hook plate fixation in type 5 acromioclavicular joint dislocations: a retrospective cohort study

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