Stabilization of Acute High-Grade Acromioclavicular Joint Separation: A Prospective Assessment of the Clavicular Hook Plate Versus the Double Double-Button Suture Procedure

Stein, Thomas; Müller, Daniel; Blank, Manfred; Reinig, Y.; Saier, Tim; Hoffmann, Reinhard; Welsch, F.; Schweigkofler, Uwe

doi:10.1177/0363546518788355

“…No infection case was noted in both groups [16]. The inferior functional outcome of hook plate xation may be attributed to different rehabilitation protocols, concomitant lesions, and vertical or horizontal instability after removal of the implants [15]. Therefore, we presumed that concomitant CC reconstruction with hook plate xation could reduce the vertical instability with load-sharing from the acromion to the coracoid and clavicle, especially after implant removal.…”

Section: Discussionmentioning

confidence: 92%

“…A series of plain lms, including AP and outlet views, was obtained prior to surgery, on postoperative day 1, and 1, 3, 6 and 12 months postoperatively. In the radiographic assessment, as Stein et al mentioned, three lines were drawn horizontal to the ground: the coracoidal parallel line was drawn through the superior cortex of the coracoid; the acromial parallel line was drawn through the inferior acromial cortex; and the clavicular parallel line was drawn through the inferior clavicular cortex [15]. The absolute coracoclavicular distance (aCCD) refers to the distance between the clavicular parallel line and the coracoid parallel line, while the absolute acromiocoracoid distance (ACD) was de ned as the distance between the acromial parallel line and the coracoidal parallel line.…”

Section: Radiographic Assessmentmentioning

confidence: 99%

Is Coracoclavicular Reconstruction Necessary in Hook Plate Fixation for Acute Unstable Acromioclavicular Dislocation?

Chen

¹

,

Wu

²

,

Jhan

³

et al. 2020

Preprint

0

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Background: Acromioclavicular joint (ACJ) dislocation is a relatively common shoulder injury. For the treatment of cases of severe ACJ dislocation (Rockwood type III–V), hook plate fixation is an easy-to-master and minimally-invasive approach to surgical intervention. Overstress on the acromion following hook plate fixation often leads to acromial complications such as osteolysis and loss of reduction. We hypothesized that suspensory reconstruction alongside hook plate fixation might provide a superior stability and reduce complications as compared with hook plate fixation alone. The purpose of the study was to assess the clinical and radiographic outcomes of these two surgical modalities.Methods: We retrospectively enrolled 38 patients with acute ACJ dislocation from May 2010 to December 2018. Among them, nineteen patients received hook plate fixation only (HP group), and 19 underwent concomitant hook plate fixation and loop suspension fixation with two mersilene tapes (HM group). The demographic data of the patients were recorded and analyzed. All patients underwent a shoulder x-ray initially, immediately postoperatively, and at 1, 3, 6 and 12 months to measure the relative coracoclavicular distance (rCCD). Clinical assessment of shoulder function outcome was conducted using the Constant Murley Score (CMS); the University of California at Los Angeles (UCLA) Shoulder Score was also measured at the latest follow-up.Results: There were no significant differences in the demographic data between the two groups. With regards to the CMS and the UCLA score, the HM group and HP group both had excellent outcomes, and no significant differences in scores were observed between groups (CMS: 93.90 ± 6.16 versus 94.47 ± 7.26, p = 0.47; UCLA score: 32.84 ± 2.91 versus 34.32 ± 1.16, p = 0.07). However, the HM group demonstrated substantial superiority in terms of maintenance of the rCCD over the HP group (91.47 ± 27.47 versus 100.75 ± 48.70, p = 0.015). In addition, there was less subacromial osteolysis in the HM group than the HP group (52.6% versus 15.8%, p = 0.038).Conclusion: Concomitant hook plate fixation with loop suspensory reconstruction yielded excellent functional outcomes and superior maintenance of the rCCD with fewer acromion complications than hook plate fixation alone.

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“…mentioned, three lines were drawn horizontal to the ground: the coracoidal parallel line was drawn through the superior cortex of the coracoid; the acromial parallel line was drawn through the inferior acromial cortex; and the clavicular parallel line was drawn through the inferior clavicular cortex [15]. The absolute coracoclavicular distance (aCCD) refers to the distance between the clavicular parallel line and the coracoid parallel line, while the absolute acromiocoracoid distance (ACD) was de ned as the distance between the acromial parallel line and the coracoidal parallel line.…”

Section: Radiographic Assessmentmentioning

confidence: 99%

“…[16]. The inferior functional outcome of hook plate xation may be attributed to different rehabilitation protocols, concomitant lesions, and vertical or horizontal instability after removal of the implants [15]. Therefore, we presumed that concomitant CC reconstruction with hook plate xation could reduce the vertical instability with load-sharing from the acromion to the coracoid and clavicle, especially after implant removal.…”

Section: Radiographic Outcomementioning

confidence: 99%

Is Coracoclavicular Reconstruction Necessary in Hook Plate Fixation for Acute Unstable Acromioclavicular Dislocation?

Chen

¹

,

Wu

²

,

Jhan

³

et al. 2020

Preprint

0

View full text Add to dashboard Cite

Background: Acromioclavicular joint (ACJ) dislocation is a relatively common shoulder injury. For the treatment of cases of severe ACJ dislocation (Rockwood type III–V), hook plate fixation is an easy-to-master and minimally-invasive approach to surgical intervention. Overstress on the acromion following hook plate fixation often leads to acromial complications such as osteolysis and loss of reduction. We hypothesized that suspensory reconstruction alongside hook plate fixation might provide a superior stability and reduce complications as compared with hook plate fixation alone. The purpose of the study was to assess the clinical and radiographic outcomes of these two surgical modalities.Methods: We retrospectively enrolled 38 patients with acute ACJ dislocation from May 2010 to December 2018. Among them, nineteen patients received hook plate fixation only (HP group), and 19 underwent concomitant hook plate fixation and loop suspension fixation with two mersilene tapes (HM group). The demographic data of the patients were recorded and analyzed. All patients underwent a shoulder x-ray initially, immediately postoperatively, and at 1, 3, 6 and 12 months to measure the relative coracoclavicular distance (rCCD). Clinical assessment of shoulder function outcome was conducted using the Constant Murley Score (CMS); the University of California at Los Angeles (UCLA) Shoulder Score was also measured at the latest follow-up.Results: There were no significant differences in the demographic data between the two groups. With regards to the CMS and the UCLA score, the HM group and HP group both had excellent outcomes, and no significant differences in scores were observed between groups (CMS: 93.90 ± 6.16 versus 94.47 ± 7.26, p = 0.47; UCLA score: 32.84 ± 2.91 versus 34.32 ± 1.16, p = 0.07). However, the HM group demonstrated substantial superiority in terms of maintenance of the rCCD over the HP group (91.47 ± 27.47 versus 100.75 ± 48.70, p = 0.015). In addition, there was less subacromial osteolysis in the HM group than the HP group (52.6% versus 15.8%, p = 0.038).Conclusion: Concomitant hook plate fixation with loop suspensory reconstruction yielded excellent functional outcomes and superior maintenance of the rCCD with fewer acromion complications than hook plate fixation alone.

show abstract

“…A series of plain lms, including AP and outlet views, was obtained prior to surgery, on postoperative day 1, and 1, 3, 6 and 12 months postoperatively. In the radiographic assessment, three lines were drawn horizontal to the ground: the coracoidal parallel line was drawn through the superior cortex of the coracoid; the acromial parallel line was drawn through the inferior acromial cortex; and the clavicular parallel line was drawn through the inferior clavicular cortex [19]. The absolute coracoclavicular distance (aCCD) refers to the distance between the clavicular parallel line and the coracoid parallel line, while the absolute acromiocoracoid distance (ACD) was de ned as the distance between the acromial parallel line and the coracoidal parallel line.…”

Section: Radiographic Assessmentmentioning

confidence: 99%

Is coracoclavicular reconstruction necessary in hook plate fixation for acute unstable acromioclavicular dislocation?

Chen

¹

,

Wu

²

,

Jhan

³

et al. 2020

Preprint

0

View full text Add to dashboard Cite

Background Acromioclavicular joint (ACJ) dislocation is a relatively common shoulder injury. For the treatment of cases of severe ACJ dislocation (Rockwood type III–V), hook plate fixation is an easy-to-master and minimally-invasive approach to surgical intervention. Overstress on the acromion following hook plate fixation often leads to acromial complications such as osteolysis and loss of reduction. We hypothesized that suspensory reconstruction alongside hook plate fixation might provide a superior stability and reduce complications as compared with hook plate fixation alone. The purpose of the study was to assess the clinical and radiographic outcomes of these two surgical modalities. Methods We retrospectively enrolled 38 patients with acute ACJ dislocation from May 2010 to December 2018. Among them, nineteen patients received hook plate fixation only (HP group), and 19 underwent concomitant hook plate fixation and loop suspension fixation with two mersilene sutures (HM group). The demographic data of the patients were recorded and analyzed. All patients underwent a shoulder x-ray initially, immediately postoperatively, and at 1, 3, 6 and 12 months to measure the relative coracoclavicular distance (rCCD). Clinical assessment of shoulder function outcome was conducted using the Constant Murley Score (CMS); the University of California at Los Angeles (UCLA) Shoulder Score was also measured at the latest follow-up. Results There were no significant differences in the demographic data between the two groups. With regards to the CMS and the UCLA score, the HM group and HP group both had excellent outcomes, and no significant differences in scores were observed between groups (CMS: 93.90 ± 6.16 versus 94.47 ± 7.26, p = 0.47; UCLA score: 32.84 ± 2.91 versus 34.32 ± 1.16, p = 0.07). However, the HM group demonstrated substantial superiority in terms of maintenance of the rCCD over the HP group (91.47 ± 27.47 versus 100.75 ± 48.70, p = 0.015). In addition, there was less subacromial osteolysis in the HM group than the HP group (52.6% versus 15.8%, p = 0.038). Conclusion Concomitant hook plate fixation with loop suspensory reconstruction yielded excellent functional outcomes and superior maintenance of the rCCD with fewer acromion complications than hook plate fixation alone.

show abstract

Stabilization of Acute High-Grade Acromioclavicular Joint Separation: A Prospective Assessment of the Clavicular Hook Plate Versus the Double Double-Button Suture Procedure

Cited by 74 publications

References 36 publications

Is Coracoclavicular Reconstruction Necessary in Hook Plate Fixation for Acute Unstable Acromioclavicular Dislocation?

Is Coracoclavicular Reconstruction Necessary in Hook Plate Fixation for Acute Unstable Acromioclavicular Dislocation?

Is Coracoclavicular Reconstruction Necessary in Hook Plate Fixation for Acute Unstable Acromioclavicular Dislocation?

Is coracoclavicular reconstruction necessary in hook plate fixation for acute unstable acromioclavicular dislocation?

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