Failure of acromioclavicular reconstruction using Gore-Tex graft due to aseptic foreign-body reaction and clavicle osteolysis: A case report

Stewart, Andrew M.; Ahmad, Christopher S.

doi:10.1016/j.jse.2004.01.027

Cited by 19 publications

(11 citation statements)

References 54 publications

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“…2,3 The lateral ulnar collateral ligament (LUCL) is the principal stabilizer of the posterolateral elbow, and its stabilization or reconstruction is the principle method for the management of symptomatic PLRI. [14][15][16] There is a single report in the literature of osteolysis following the use of Surgilig/LockDown to reconstruct the ACJ 17 and would appear to be a very safe and effective method of gaining immediate stability and return of function in extra-articular reconstructions. 4 In asymptomatic patients, or in those where surgery is contraindicated, nonoperative techniques such as avoidance of activities that cause instability, elbow bracing or application of a sugar tong cast, and physical therapy may be considered.…”

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confidence: 99%

Surgical Repair of Posterolateral Rotatory Instability of the Elbow Using Surgilig/LockDown

Williams

Martin

Mascio

2014

Techniques in Shoulder &Amp; Elbow Surgery

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Posterolateral rotatory instability (PLRI) of the elbow is the most common type of chronic elbow instability and is principally due to lateral ulnar collateral ligament injury. We describe a novel surgical technique for the treatment of PLRI using the Surgilig/ LockDown. Using this tensioned double-braided polyester synthetic ligament to reconstruct the lateral ulnar collateral ligament it is possible to reconstitute elbow stability. Through a global posterior midline incision, a Surgilig/LockDown synthetic ligament is first secured to the proximal ulnar and then passed through a bone tunnel from the isometric point of the lateral epicondyle, along the lateral column, exiting the posterior aspect of the supracondylar ridge where it is tensioned and secured with bicortical screw fixation. We present 2 cases where Surgilig has been used to treat PLRI in a primary and revision scenario. Our early findings have found that this method confers good elbow stability and immediate motion without the need for allograft harvesting or multiple tendon routing in both primary and revision reconstruction of the elbow.

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confidence: 99%

Surgical Repair of Posterolateral Rotatory Instability of the Elbow Using Surgilig/LockDown

Williams

Martin

Mascio

2014

Techniques in Shoulder &Amp; Elbow Surgery

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“…Various other suture materials, including PDS (Ethicon Inc., Somerville, NJ, USA) [9], Merselene (Ethicon Inc.) [10] and carbon fibres [11], have been used to stabilize the ACJ, although they suffer from an increased risk of bone erosion and subsequent failure as a result of a small contact surface area with the bone and resulting high stress. There have also been reports of foreign body reactions using other materials, such as PDS (Ethicon Inc.) [12] and Gore Tex graft (Gore, Flagstaff, AZ, USA) [13].…”

Section: Discussionmentioning

confidence: 99%

Bone Osteolysis Following Acromioclavicular Joint Reconstruction Using Synthetic Ligament (Surgilig™)

2014

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Good short term results have led to increased use of synthetic ligaments for acute and chronic acromioclavicular joint (ACJ) disruption. They have proved quite safe in the short term but we present two cases of osteolysis following ACJ reconstruction using a synthetic ligament, reminding surgeons of potential complications with artificial ligaments. A high index of suspicion is needed to diagnose such complications early before irretrievable bone loss to osteolysis. INTRODUCTIONThe Nottingham Surgilig™ (Surgicraft, Redditch, UK) was introduced in 2001 as a means of addressing failed acromioclavicular joint (ACJ) surgery [1]. The ligament comprises a braided synthetic polyester ligament with loops on both ends to reconstruct the disrupted coracoclavicular ligaments. The technique involves looping the ligament around the coracoid and securing to the distal clavicle with a screw, thus providing strong fixation. Its use has increased over last 5 years and, although originally intended for failed ACJ reconstructions, it is increasingly being used as primary method of stabilization [2,3] in Rockwood type III-V injuries [4].Potential complications reported so far include coracoid fracture [1] and skin irritation from the retaining screw, necessitating removal [2]. A recent case report [5] described distal clavicle osteolysis following primary fixation of a Rockwood type III injury using Surgilig. This mode of failure presents challenge for the salvage as a result of the bone loss involved, and can be particularly difficult if it leads to significant erosion of the coracoid process. We report two cases of osteolysis in our practice, one of which involved the coracoid process, following fixation with Surgilig.

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“…So far, these cases have involved the use of PDS coracoclavicular slings,[29] Gore-Tex graft,[30] and Dacron. [31] Osteolysis of the distal clavicle following ACJ dislocation surgery with similar products suggests the need for further evaluation of the products currently in use to ensure that this is not a more common occurrence than previously anticipated.…”

Section: Discussionmentioning

confidence: 99%

Distal clavicle osteolysis following fixation with a synthetic ligament

Dearden¹,

Ferran²,

Morris³

2011

Int J Shoulder Surg

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Failure of acromioclavicular reconstruction using Gore-Tex graft due to aseptic foreign-body reaction and clavicle osteolysis: A case report

Cited by 19 publications

References 54 publications

Surgical Repair of Posterolateral Rotatory Instability of the Elbow Using Surgilig/LockDown

Surgical Repair of Posterolateral Rotatory Instability of the Elbow Using Surgilig/LockDown

Bone Osteolysis Following Acromioclavicular Joint Reconstruction Using Synthetic Ligament (Surgilig™)

Distal clavicle osteolysis following fixation with a synthetic ligament

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