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

2019 ◽  
Vol 8 (10) ◽  
pp. 1683 ◽  
Author(s):  
Robert Breuer ◽  
Alexandra Unterrainer ◽  
Micha Komjati ◽  
Thomas M. Tiefenboeck ◽  
Klemens Trieb ◽  
...  
Keyword(s):  
Los Angeles ◽  
Constant Score ◽  
Sports Injury ◽  
Negative Influence ◽  
Time Interval ◽  
X Rays ◽  
Ac Joint ◽  
Joint Dislocation ◽  
Horizontal Instability ◽  
Ac Joint Dislocation

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.

scholarly journals The Infinity-Lock System for Chronic Grade III AC Joint Dislocation: A Novel Technique, Rehabilitation Protocol and Short Term Results

2020 ◽  
Vol 9 (8) ◽  
pp. 2519
Author(s):  
Alfonso Maria Romano ◽  
Pasquale Casillo ◽  
Monica De Simone ◽  
Guglielmo Nastrucci ◽  
Donatella Risorto ◽  
...  
Keyword(s):  
Constant Score ◽  
Surgical Techniques ◽  
Nonoperative Treatment ◽  
Modified Technique ◽  
Ac Joint ◽  
Joint Dislocation ◽  
Ac Joint Dislocation ◽  
Choice Of Treatment ◽  
Grade Iii

Background: the choice of treatment of chronic grade III acromioclavicular (AC) joint dislocation is controversial. Several surgical techniques have been described in the literature, responding differently to nonoperative treatment. The aim of this study is to describe a modified technique of stabilizing an AC joint dislocation with the new Infinity-Lock Button System, in order to demonstrate that it is effective in optimizing outcomes and decreasing complications. Methods: this is a retrospective study of 15 patients who underwent surgical stabilization of the AC joint dislocation between 2018 and 2019, through modified surgical technique using the Infinity-Lock Button System. Active range of motion (ROM), Specific Acromio Clavicular Score (SACS) and Constant Score (CS) were evaluated preoperatively and postoperatively at last 18 months follow up. Patients rated their outcomes as very good, good, satisfactory, or unsatisfactory. Results: a total of twelve patients rated their outcome as very good and three as good; no patients were dissatisfied with surgery. The mean Constant Score increased from 38 points preoperatively to 95 postoperatively, the average SACS score decreased from 52 points preoperatively to 10 postoperatively, both significantly. No complications were detected. Conclusion: the described technique is effective for treatment of chronic grade III AC joint dislocation, resulting in elevated satisfaction ratings and predictable outcomes. Nevertheless, further longer term follow-up studies are required.

scholarly journals Clinical and Radiological Outcomes of Modified Phemister Operation with Coracoclavicular Ligament Augmentation Using Suture Anchor for Acute Acromioclavicular Joint Dislocation

2019 ◽  
Vol 22 (2) ◽  
pp. 93-99
Author(s):  
Nam Su Cho ◽  
Sung Ju Bae ◽  
Joong Won Lee ◽  
Jeung Hwan Seo ◽  
Yong Girl Rhee
Keyword(s):  
Suture Anchor ◽  
External Rotation ◽  
Constant Score ◽  
Acromioclavicular Joint Dislocation ◽  
Ac Joint ◽  
Joint Dislocation ◽  
Ligament Augmentation ◽  
Ac Joint Dislocation ◽  
The Mean

Background: Modified Phemister operation has been widely used for the treatment of acute acromioclavicular (AC) joint dislocation. Additionally, the use of suture anchor for coracoclavicular (CC) fixation has been reported to provide CC stability. This study was conducted to evaluate the clinical and radiological results of a modified Phemister operation with CC ligament augmentation using suture anchor for acute AC joint dislocation.Methods: Seventy-four patients underwent the modified Phemister operation with CC ligament augmentation using suture anchor for acute AC joint dislocation and were followed-up for an average of 12.3 months. The visual analogue scale (VAS), range of motion, Constant score, and Korean shoulder scoring system (KSS) were used for clinical assessment. Acromioclavicular interval (ACI), coracoclavicular distance (CCD), and acromioclavicular distance (ACD) were obtained to evaluate the radiological assessments.Results: At the last follow-up, the mean VAS Score was 1.7 points, the mean joint range of the forward flexion was 164.6°, external rotation at the side was 61.2°, and internal rotation to the posterior was a level of T12. The mean Constant score and the mean KSS was 82.7 points and 84.2 points, respectively. At the mean ACI, CCD, and ACD, significant differences were found preoperatively and at the last follow-up. When the ACI, CCD, and ACD were compared with the contralateral unaffected shoulder at the last follow-up, the affected shoulders had significantly higher values.Conclusions: The modified Phemister operation with CC ligament augmentation using suture anchor is clinically and radiologically effective at acute AC joint dislocation.

Suture Button Versus Hook Plate for Acute Unstable Acromioclavicular Joint Dislocation: A Meta-analysis

2019 ◽  
Vol 48 (4) ◽  
pp. 1023-1030 ◽  
Author(s):  
Cong Wang ◽  
Jia-Hong Meng ◽  
Yi-Wen Zhang ◽  
Ming-Min Shi
Keyword(s):  
Functional Outcomes ◽  
Constant Score ◽  
Meta Analysis ◽  
Operation Time ◽  
Analog Scale ◽  
Ac Joint ◽  
Joint Dislocation ◽  
Loss Of Reduction ◽  
Ac Joint Dislocation ◽  
Coracoclavicular Distance

Background: Surgical treatment is indicated for unstable acromioclavicular (AC) joint dislocation. The hook plate (HP) technique is a commonly used treatment method, but the use of the suture button (SB) technique is increasing. Purpose: To conduct a meta-analysis of clinical studies evaluating patient outcomes between the SB and HP techniques for acute unstable AC joint dislocation. Study Design: Meta-analysis. Methods: A literature search of the Embase, PubMed, and Cochrane Library databases was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Cohort studies and case-control studies comparing the SB and HP procedures for acute unstable AC joint dislocation were included. Statistical analysis was performed with RevMan (v 5.3.5). Results: Eight clinical studies that met the inclusion criteria were identified and included a total of 204 patients treated with the SB technique and 195 patients with the HP technique. Patients treated with the SB technique had a higher Constant score (mean difference [MD], 3.95; 95% CI, 1.20-6.70; P = .005) and a lower visual analog scale pain score (MD, –0.75; 95% CI, –1.12 to 0.37; P < .0001) when compared with the HP technique. No significant differences in operation time (MD, –0.38; 95% CI, –7.14 to 6.37; P = .91), coracoclavicular distance (MD, –0.07; 95% CI, –0.49 to 0.35; P = .75), complications (odds ratio, 0.59; 95% CI, 0.22-1.54; P = .28), and loss of reduction (odds ratio, 2.55; 95% CI, 0.66-9.83; P = .17) were found between the SB and HP techniques. The subgroup analysis showed that the arthroscopic SB technique resulted in a higher Constant score (MD, 6.75; 95% CI, 4.21-9.29; P < .00001) as compared with the HP technique, but no differences were observed between the open SB and HP techniques (MD, 0.69; 95% CI, –0.82 to 2.20; P = .37). Conclusion: This meta-analysis demonstrated that the SB technique resulted in better functional outcomes and a reduced visual analog scale pain score when compared with the HP technique. However, for operation time, coracoclavicular distance, complications, and loss of reduction, there were no statistically significant differences between the techniques. Compared with the open procedure, arthroscopic SB may be superior for better functional outcomes.

scholarly journals Treatment of chronic acromioclavicular joint dislocation in a paraplegic patient with the Weaver-Dunn procedure and a hook-plate

2016 ◽  
Vol 8 (2) ◽  
Author(s):  
Holger Godry ◽  
Mustafa Citak ◽  
Matthias Königshausen ◽  
Thomas A. Schildhauer ◽  
Dominik Seybold
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Weight Bearing ◽  
Full Range ◽  
Hook Plate ◽  
Acromioclavicular Joint Dislocation ◽  
Ac Joint ◽  
Joint Dislocation ◽  
Ac Joint Dislocation ◽  
Cord Injury

Abstract In case of patients with spinal cord injury and concomitant acromioclavicular (AC) jointdislocation the treatment is challenging, as in this special patient group the function of the shoulder joint is critical because patients depend on the upper limb for mobilization and wheelchair-locomotion. Therefore the goal of this study was to examine, if the treatment of chronic AC-joint dislocation using the Weaver- Dunn procedure augmented with a hook-plate in patients with a spinal cord injury makes early postoperative wheelchair mobilization and the wheelchair transfer with full weightbearing possible. In this case the Weaver- Dunn procedure with an additive hook-plate was performed in a 34-year-old male patient with a complete paraplegia and a posttraumatic chronic AC-joint dislocation. The patient was allowed to perform his wheelchair transfers with full weight bearing on the first postoperative day. The removal of the hook-plate was performed four months after implantation. At the time of follow-up the patient could use his operated shoulder with full range of motion without restrictions in his activities of daily living or his wheel-chair transfers.

scholarly journals Clinical and Radiological Results of Hook Plate Fixation in Acute Acromioclavicular Joint Dislocations and Distal Clavicle Fractures

2018 ◽  
Vol 21 (2) ◽  
pp. 95-100
Author(s):  
Joo Han Oh ◽  
Seunggi Min ◽  
Jae Wook Jung ◽  
Hee June Kim ◽  
Jae Yoon Kim ◽  
...  
Keyword(s):  
Plate Fixation ◽  
Clavicle Fracture ◽  
Hook Plate ◽  
Distal Clavicle ◽  
Ac Joint ◽  
Joint Dislocation ◽  
Group I ◽  
Joint Dislocations ◽  
Ac Joint Dislocation ◽  
Group Ii

BACKGROUND: The purpose of this study was to evaluate the clinical outcomes and complications of hook plate fixation in acromioclavicular (AC) joint dislocations and distal clavicle fractures.METHODS: We retrospectively reviewed a series of 60 consecutive patients with hook plate fixation for AC joint dislocation (group I) and distal clavicle fracture (group II). Groups I and II had 39 and 21 patients, respectively. Clinical results were evaluated using the pain visual analogue scale (VAS), simple shoulder test, and Constant-Murley scores. In addition, subacromial erosion and stiffness were evaluated as complications.RESULTS: At the removal, the pain VAS was 2.69 ± 1.30 and 4.10 ± 2.14 in groups I and II, respectively, which were significantly different (p=0.003). The simple shoulder test score was 9.59 ± 1.60 and 7.81 ± 2.67 in groups I and II, respectively, which were also significantly different (p=0.002). Subacromial erosion was significantly more frequent in group II (14/21 patients, 66.7%) than in group I (15/39 patients, 38.5%) (p=0.037), and stiffness was also higher in group II (17/21 patients, 81.0%) than in group I (22/39 patients, 56.4%), but it was not significant.CONCLUSIONS: Hook plate fixation showed good clinical and functional results for the treatment of acute unstable AC joint dislocation and distal clavicle fracture. But, in distal clavicle fractures, there are more subacromial erosion and stiffness compare with acute unstable AC joint dislocation.

scholarly journals Ipsilateral midshaft clavicle fracture and acromioclavicular joint dislocation: a review of literature and evidence-based diagnosis guidelines

2020 ◽  
Author(s):  
Rongguang Ao ◽  
Zhen Jian ◽  
Jinhong Chen ◽  
Dejian Li ◽  
Xu Zhang ◽  
...  
Keyword(s):  
Clavicle Fracture ◽  
High Energy ◽  
Shoulder Function ◽  
Acromioclavicular Joint Dislocation ◽  
Evidence Based ◽  
Ac Joint ◽  
Level Of Evidence ◽  
Joint Dislocation ◽  
Type Iv ◽  
Ac Joint Dislocation

Abstract Background: Ipsilateral midshaft clavicle fracture and AC joint dislocation are rare, with very few cases reported. Once the AC joint dislocation were missed diagnosis, the shoulder function may be affected and medical dispute was easy to occur. The aim of this study was to gather data relating to ipsilateral midshaft clavicle fracture and AC joint dislocation to develop evidence-based diagnosis guidelines as none are currently available.Methods: A study was conducted of the PubMed and Google Scholar databases to identify cases of ipsilateral midshaft clavicle fracture and AC joint dislocation. Data collected about each case included age and gender of the patient, mechanism of injury, fracture and dislocation classification. The authors report 2 additional ipsilateral midshaft clavicle fracture and AC joint dislocation cases.Results: 21 cases were identified for inclusion in this research, 19 from the literature and 2 reported by the authors. All the patients were injured by high energy trauma. For the midshaft fracture, 16/21 (76.2%) patients belonged to Type A classification, and 5/21 (23.8%) patients belonged to Type B classification. For AC joint dislocation, 11/21 (47.6%) patients belonged to Type IV classification, 4/21 (19.0%) patients belonged to Type VI classification, 5/21 (23.8%) patients belonged to Type III classification and 1/21 (4.7%) patients belonged to Type V classification.Conclusions: There are limited data available about the diagnosis of ipsilateral midshaft clavicle fracture and AC joint dislocation. From the cases reviewed, we find that simple midshaft clavicle caused by high energy injuries may be associated with ipsilateral AC joint dislocation. Physical examination, careful observation of preoperative X-ray and fluoroscopy including the AC joint during operation were key to diagnose the injury. Level of Evidence Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Early clinical results of minimally invasive coracoclavicular ligament reconstruction can be maintained at a minimum of five years’ follow-up

2020 ◽  
Vol 102-B (7) ◽  
pp. 918-924
Author(s):  
Steffen B. Rosslenbroich ◽  
Katharina Heimann ◽  
Jan Christoph Katthagen ◽  
Clemens Koesters ◽  
Oliver Riesenbeck ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Constant Score ◽  
Clinical Results ◽  
Long Term Results ◽  
Short Term ◽  
Ac Joint ◽  
Ac Joint Dislocation ◽  
Significant Difference

Aims There is a lack of long-term data for minimally invasive acromioclavicular (AC) joint repair. Furthermore, it is not clear if good early clinical results can be maintained over time. The purpose of this study was to report long-term results of minimally invasive AC joint reconstruction (MINAR) and compare it to corresponding short-term data. Methods We assessed patients with a follow-up of at least five years after minimally invasive flip-button repair for high-grade AC joint dislocation. The clinical outcome was evaluated using the Constant score and a questionnaire. Ultrasound determined the coracoclavicular (CC) distance. Results of the current follow-up were compared to the short-term results of the same cohort. Results A total of 50 patients (three females, 47 males) were successfully followed up for a minimum of five years. The mean follow-up was 7.7 years (63 months to 132 months). The overall Constant score was 94.4 points (54 to 100) versus 97.7 points (83 to 100) for the contralateral side showing a significant difference for the operated shoulder (p = 0.013) The mean difference in the CC distance between the operated and the contralateral shoulder was 3.7 mm (0.2 to 7.8; p = 0.010). In total, 16% (n = 8) of patients showed recurrent instability. All these cases were performed within the first 16 months after introduction of this technique. A total of 84% (n = 42) of the patients were able to return to their previous occupations and sport activities. Comparison of short-term and long-term results revealed no significant difference for the Constant Score (p = 0.348) and the CC distance (p = 0.974). Conclusion The clinical outcome of MINAR is good to excellent after long-term follow-up and no significant differences were found compared to short-term results. We therefore suggest this is a reliable technique for surgical treatment of high-grade AC joint dislocation. Cite this article: Bone Joint J 2020;102-B(7):918–924.

Acromion Fracture and Acromioclavicular Joint Dislocation: A Case Report

2020 ◽  
Author(s):  
Mohammad Zarei ◽  
Saied Besharaty ◽  
Alireza Moharrami ◽  
Rasul Ghaedi
Keyword(s):  
Acromioclavicular Joint Dislocation ◽  
Early Recovery ◽  
Ac Joint ◽  
Early Management ◽  
Case Presentation ◽  
Joint Dislocation ◽  
Ac Joint Dislocation ◽  
Acromion Fracture ◽  
Acromial Fracture ◽  
Clavicle Fractures

Background: Acromion fractures are rare injuries that may occur because of shoulder trauma. This may be associated with distal clavicle fractures, which can be an indication for surgery. There are several methods, which are used for fixation of this type of fractures. Case Presentation: In this paper, we presented a 34 years old man with acromion fracture in contribution with acromioclavicular (AC) joint dislocation. We applied a new method for fixation of this fracture. The fracture was fixed by 2 screws and AC Joint was fixed by a 4-hole hook plate. Conclusions: It is important to be aware of acromial fracture to not miss them and also for early management, so that early recovery and satisfactory results can be gained

scholarly journals Comparative Outcome of Loop Suspensory Reconstruction and Hook Plate Fixation for Acute Type III-V Acromioclavicular Joint Dislocation

2020 ◽  
Author(s):  
Yu-Jui Chang ◽  
Wen-Yi Chou ◽  
Jih-Yang Ko ◽  
Hao-Chen Liu ◽  
Ya-Ju Yang ◽  
...  
Keyword(s):  
Plate Fixation ◽  
Hook Plate ◽  
Ac Joint ◽  
Joint Dislocation ◽  
Constant Murley Score ◽  
Group I ◽  
Ac Joint Dislocation ◽  
Group Ii ◽  
Reconstruction Group

Abstract Background Treatment options of acromioclavicular (AC) joint dislocation depend on the injury severity and the functional demand of the patient. Common surgical options include fixation across the AC joint, coracoclavicular (CC) fixation, and AC joint or CC reconstruction. However, the clinical superiority of these various procedures is controversial. This study aimed to compare the clinical and radiological outcomes of loop suspensory reconstruction and hook plate fixation for acute unstable AC joint dislocation.Methods We retrospectively included patients with acute unstable AC joint dislocation who were treated with loop suspensory reconstruction (group I, 23 cases) or hook plate fixation (group II, 14 cases) in our hospital from January 2010 to December 2016 with a minimum follow-up period of 1 year after surgery. We assessed the clinical outcomes of blood loss during surgery, surgical duration, duration of medication required for pain relief after the primary operation, occurrence of complications, and the Constant-Murley score; radiological analysis included postoperative arthritic change and the CC distance discrepancy ratio (CCDR) on preoperative and final follow-up plain films.Results The average follow-up duration was17.0±6.1 months. The mean duration of pain-control medication usage was 121.7±174.1 and 235.4±251.8 days in groups I and II, respectively, significantly lower in the CC reconstruction group (p=0.031). Group I revealed a superior Constant-Murley score at the final outpatient follow-up as compared with group II (71.7±15.8 vs 61.1±6.7, p=0.009). Regarding radiographic analysis, the hook plate group had a superior residual CCDR (group I vs II = 30% vs 80±40%, p<0.001). In addition, there were 9 cases of subluxation noted in group I and 2 cases in group II; however, 4 cases of acromion osteolysis were observed in group II.Conclusions The principle finding of the present study was that hook plate fixation was superior to loop suspensory reconstruction in terms of CC distance maintenance. However, the loop suspensory reconstruction group demonstrated superior clinical functional outcomes and less painkiller usage. A further randomized controlled trial with a long-term follow-up period is required.

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