Minimally Invasive AC Joint Reconstruction System (MINAR®) in Modified Triple-Button Technique for the Treatment of Acute AC Joint Dislocation

Abstract

Acute acromioclavicular (AC) joint dislocation is a frequent sports injury with more than 100 different operation methods described. A total of 65 patients with an acute AC joint dislocation were treated with the modified MINAR® system between 2009 and 2013. Clinical outcome, horizontal and vertical instability, as well as concomitant intraarticular injuries were assessed. We used Zanca, stress and axial X-rays for radiological assessment. A Constant score of 95 (±8.8), University of California Los Angeles Shoulder score (UCLA) of 31 (±4.9), Disabilities of Arm, Shoulder and Hand (DASH) of 9.1 (±14.3), and Visual Analogue Scale (VAS) of 0.9 (±0.126) was found. A total of 30 patients (59%) had no signs of reduction loss, nine patients (18%) a slight loss, 11 patients (22%) a partial loss, and one patient (2%) a total loss. No significant influence on the clinical scores could be shown. The postoperative coracoclavicular (CC) distance negatively affected the Constant (p = 0.007) and UCLA scores (p = 0.035). A longer time interval to surgery had a negative influence on all scores (p ≤ 0.001). We could not find any signs of persistent horizontal instability or intraarticular injuries at follow-up. The MINAR® system promises satisfactory functional and radiological results. When setting the correct indication, patients benefit from an early operation. No persisting horizontal instability was observed following suturing of the AC capsule and the delta fascia.

Biologic and synthetic ligament reconstructions achieve better functional scores compared to osteosynthesis in the treatment of acute acromioclavicular joint dislocation

“…Of these, 191 were excluded based on their abstract and 47 additional studies were excluded based on the full‐text article. One hundred and thirty‐three [1, 2, 4, 5, 7–10, 12–15, 17–23, 25, 29, 30, 32–41, 43–46, 49–52, 54–61, 64–67, 69–73, 75–82, 86–95, 97–99, 102–109, 111, 113, 117, 118, 120, 122–130, 133, 135, 137–139, 143, 144, 146–156, 158, 160–162, …”

Minimally invasive reconstruction of acute acromioclavicular joint injuries using the TwinBridge button system

“…Another possible explanation of the high radiological failure rate might be the use of only one clavicular button and the non-absorbable suture in the MINAR system. However, results of a modified technique with one coracoidal and two clavicular buttons published by Breuer et al [ 7 ] showed a loss of reduction of 2.1 mm side-to-side difference of the CC distance. In their study, 59% of the patients did not have any loss of reduction.…”

Mini open triple tunnel- double flip button techniques in treatment of acute acromioclavicular joint injuries: Case report

“…Many surgery techniques were introduced to treat acute AC injuries – more than 100 techniques – by creating single and double tunnels at the clavicle [ 3 ]. Rosslenbroich et al introduced MINAR (minimally invasive acromioclavicular joint reconstruction) widely used by many surgeons [ 2 ].…”

“…Breur et al modified this technique with the double tunnel at the clavicle by using triple buttons. Some loss of reduction still become an issue during the follow-up [ 3 ]. Moreover, some biomechanical studies showed that there was no difference in bidirectional strength and stability between the single-and double-clavicle tunnel techniques of coracoclavicular reconstruction.…”

“…Breur et al introduced triple button technique with double tunnel at clavicle. However, some loss of reduction still become some issues during follow-up [ 3 ]. In this paper, we introduce the TTDB technique to minimize this complication.…”