The Kite technique: a new all-arthroscopic technique for the treatment of acute acromioclavicular joint dislocation

Abstract

PurposeAlthough many open techniques have been developed, no all‐arthroscopic technique has been introduced to reduce acute acromioclavicular joint dislocation (ACJD) and augment both coracoclavicular (CC) ligaments. The Kite technique is the first all arthroscopic technique with this aim. MethodsForty‐one consecutive patients [35M–6F; median: 29.2 years (range 23–36)] with acute type III and V acromioclavicular joint dislocation were treated with the Kite technique: it consists of positioning three titanium buttons connected by heavy sutures in an 8‐strand configuration between clavicle and coracoid to restore the anatomy of CC ligaments. Patients were followed up for a median of 35 months (range 30–43 months). ResultsMedian operation time was 70.6 min (range 58–82), with no cases of intra‐operative complications. At the final follow‐up, the median post‐operative Constant Score and SST were 94.1 (range 89–98) and 11.6 (range 10–12), respectively. At the final follow‐up reduction maintenance was present in 39 patients; in one patient, signs of acromioclavicular joint dislocation recurrence were present 3 months post‐op. In another patient, medial suture ruptures occurred 4 months after surgery with type II acromioclavicular joint dislocation recurrence but with scarce symptoms and full recovery to sport activity. Clavicle osteolysis was observed in four patients. Cosmetics of the arm were judged as excellent in 39/41. All patients, except two, were satisfied with the final result. ConclusionsThe kite technique is a safe and reproducible arthroscopic procedure to treat acute ACJD. In daily clinical practice, due to the excellent results and the low complication rate, this technique might be considered by surgeons when operative treatment of an acute acromioclavicular joint dislocation is planned. Level of evidenceIV.

Bibliometric and visualized analysis of arthroscopic treatment of acromioclavicular joint injury

“…The speed of development has slowed down since 2015, but it has maintained a steady growth. although the focus of this period is still focused on arthroscopic reconstruction of acromioclavicular ligament and coracoclavicular ligament in the treatment of acute ACJ dislocation, but ligament reconstruction techniques have been improved [31][32][33][34][35] . The United States and Tech Univ Munich are the leading countries and institutions in this eld, with 115 and 12 publications, respectively.…”

Long-term clinical and radiographic outcomes of arthroscopic acromioclavicular stabilization for acute acromioclavicular joint dislocation

“…The incidence of acute AC joint disruptions is high, accounting for 9% of all shoulder girdle injuries. Up to 40% of acute AC joint disruptions occur in elite athletes participating in competitive contact sports [ 1 , 3 , 4 ]. The mechanism of injury is typically a direct blow to the adducted shoulder or an axially directed force to the ipsilateral extremity.…”

“…The mechanism of injury is typically a direct blow to the adducted shoulder or an axially directed force to the ipsilateral extremity. The stability of the AC joint is mainly provided by the coracoclavicular (CC) and AC ligaments [ 3 ]. In 1984, Rockwood described his six-part classification system for AC joint separations, and this remains the most common classification system in use today [ 4 ].…”

“…Nonoperative management is accepted for low-grade injuries (type I and II injuries), whereas operative management is indicated for type IV to VI [ 5 ]. Significant controversy remains regarding proper diagnosis and management of type III injuries [ 1 , 3 - 6 ].…”