Acta Scientific Orthopaedics (ISSN: 2581-8635)

Research Article Volume 3 Issue 11

Arthroscopic Versus Conservative Treatment of Degenerative Meniscal Tear in Middle Aged Patients in Regard to Pain and Knee Function

Marc Banerjee1,2*, Carolin Spüntrup3, Bertil Bouillon1, Ann-Kathrin Singer1,4, Rolf Lefering5, Arasch Wafaisade1 and Maurice Balke1,6

1Department of Trauma and Orthopedic Surgery, University of Witten/Herdecke, Cologne Merheim Medical Center, Germany
2Department of Orthopedic Surgery and Sports Traumatology, Atos MediaPark Clinic, Cologne, Germany
3Pelvic School Saarbrücken, Germany
4Department of Trauma, Orthopaedic and Plastic Surgery, University of Göttingen, Germany
5IFOM, Institute for Research in Operative Medicine, University of Witten/Herdecke, Cologne Merheim Medical Center, Germany
6Sportsclinic Cologne, Cologne, Germany

*Corresponding Author: Marc Banerjee, Department of Trauma and Orthopedic Surgery, University of Witten/Herdecke, Cologne Merheim Medical Center and Department of Orthopedic Surgery and Sports Traumatology, Atos MediaPark Clinic, Cologne, Germany

Received: September 28, 2020; Published: October 30, 2020

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Abstract

Introduction: Hook plates and arthroscopic flip button techniques are currently the most commonly used procedures for AC-joint reconstruction. Minimally invasive AC-joint reconstruction (MINAR), a mini open flip button technique was introduced as an alternative to the arthroscopic technique as it is a straight forward procedure and no experience in arthroscopy is needed.

Methods: Between 2011 and 2015, 53 patients with acute AC-joint separations Type Rockwood III, IV and V were stabilized by MINAR. 45 were available for follow-up. In 15 patients a 1m m polyester suture was used, in the remaining 30 patients a No. 5 Fiberwire. All patients had a follow-up examination at a minimum one year after surgery. The Constant score (CS), the American Shoulder Elbow score (ASES) and the subjective shoulder value (SSV) were evaluated. All patients had a calibrated bilateral stress view of the AC-joints and a bilateral axial view. The coraco-clavicular (cc) distance was measured on the injured and contralateral side. Furthermore, the width of the clavicular tunnel was measured and compared with the initial diameter (4.5 mm).

Results: The mean age of the patients was 37.6 years (range 17 - 64), patients were operated after an average of 7.2 (range 1 - 20) days after trauma. After a mean of 25.3 months (range 12 - 53 months) the mean absolute CS was 96.6 (range 87 - 100), the mean ASES 98.0 (range 60 - 100) and the mean SSV was 92.3 (range 60 - 100). The cc-distance was 10.0 mm on the injured side and 8.1 mm on the uninjured side (p < 0.001). Only 14 patients (31.1%) had a perfect reduction in the vertical plane defined as a cc-distance on the injured side of ± 10% compared to the contralateral side. 20% of the patients with polyester suture and 56.7% of patients with Fiberwire had a widening of the clavicular tunnel with an average tunnel of 3.5 mm and 5.0 mm, p = 0.016.

Conclusion: Despite excellent clinical results and an average side-to-side difference of the cc-distance comparable to other techniques MINAR failed to restore the AC joint anatomically in the vertical plane. Therefor a modification of the originally described technique is advisable.

Keywords: Acromioclavicular Joint Dislocation; Acromioclavicular Joint Reconstruction; Coracoclavicular Stabilization; MINAR

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References

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Citation

Citation: Marc Banerjee., et al. “High Rate of Radiological Failure Despite Excellent Clinical Results of Minimally Invasive Acromio-Clavicular Joint Reconstruction (MINAR)".Acta Scientific Orthopaedics 3.11 (2020): 58-64.




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