Acromioclavicular Joint Dislocation Repair: A Mini Open Technique for Reconstruction of Both the Coracoclavicular (CC) and AC Joint Ligaments at a Low Cost
Juan Francisco Javier Valles Figueroa, Ramsés E Glz Jonguitud, Saúl Zapata Rivera and Melissa Olguín Rodríguez*
Department of Orthopaedics, Mexico
*Corresponding Author: Melissa Olguín Rodríguez, Department of Orthopaedics, Mexico.
Received:
November 26, 2024; Published: December 13, 2024
Abstract
AC joint dislocations are common injuries that significantly impact shoulder function. The stability of the AC joint relies on CC ligaments for vertical stability and AC ligaments and capsular structures for horizontal stability. There are various treatment options available to repair those lesions, including open, mini-open, and arthroscopically assisted techniques. Damage to AC ligaments may be overlooked but can result in chronic horizontal instability and pain. Currently, numerous surgical procedures exist for these injuries, and there is a lack of consensus regarding the optimal technique. This article introduces a mini-open technique to address CC and AC injuries, utilizing double clavicular tunnels and ultra-high-strength suture tape material for vertical instability, and an anchor in the acromion to tackle horizontal instability.
Keywords: Acromioclavicular; Reconstruction; Coracoclavicular; AC Joint Ligaments
References
- Berthold DP., et al. “Current concepts in acromioclavicular joint (AC) instability - a proposed treatment algorithm for acute and chronic AC-joint surgery”. BMC Musculoskeletal Disorders 23 (2022).
- Aliberti GM., et al. “Restoring Horizontal Stability of the Acromioclavicular Joint: Open Acromioclavicular Ligament Reconstruction and Repair with Semitendinosus Allograft”. Arthroscopy Techniques 10 (2020): e1619-1626.
- Braun S., et al. “Primary fixation of acromioclavicular joint disruption”. Operative Techniques in Sports Medicine 3 (2014): 221-226.
- Sirin E., et al. “Acromioclavicular joint injuries: Diagnosis, classification and ligamentoplasty procedures”. EFORT Open Reviews 7 (2018): 426-433.
- Chillemi C., et al. “Epidemiology of Isolated Acromioclavicular Joint Dislocation”. Emergency Medicine International 2013 (2013): 1-5.
- Dyrna FGE., et al. “The Integrity of the Acromioclavicular Capsule Ensures Physiological Centering of the Acromioclavicular Joint Under Rotational Loading”. American Journal of Sports Medicine6 (2018): 1432-1440.
- Fraser-Moodie JA., et al. “Injuries to the acromioclavicular joint”. The Journal of Bone and Joint Surgery British Volume 6 (2008): 90-697.
- Ma R., et al. “Managing and recognizing complications after treatment of acromioclavicular joint repair or reconstruction”. Current Reviews in Musculoskeletal Medicine. Humana Press Inc 8 (2015): 75-82.
- Aliberti GM., et al. “Horizontal Instability of the Acromioclavicular Joint: A Systematic Review”. American Journal of Sports Medicine. SAGE Publications Inc 48 (2020): 504-510.
- Beitzel K., et al. “ISAKOS upper extremity committee consensus statement on the need for diversification of the rockwood classification for acromioclavicular joint injuries”. Arthroscopy - Journal of Arthroscopic and Related Surgery2 (2014): 271-278.
- Gastaud O., et al. “Reliability of radiographic measurements for acromioclavicular joint separations”. Orthopaedics and Traumatology: Surgery and Research8 (2015): S291-295.
- Minkus M., et al. “Quantification of dynamic posterior translation in modified bilateral Alexander views and correlation with clinical and radiological parameters in patients with acute acromioclavicular joint instability”. Archives of Orthopaedic and Trauma Surgery 6 (2017): 845-852.
- Gutman MJ., et al. “Outcomes Following Different Fixation Strategies of Neer Type IIB Distal Clavicle Fractures”. Archives of Bone and Joint Surgery2 (2022): 160-165.
- Mazzocca AD., et al. “Evaluation and treatment of acromioclavicular joint injuries”. American Journal of Sports Medicine 35 (2007): 316-329.
- Jones HP., et al. “Salvage of Failed Acromioclavicular Joint Reconstruction Using Autogenous Semitendinosus Tendon from the Knee Surgical Technique and Case Report”. The American Journal of Sports Medicine2 (2001): 234-237.
- Yoon JP., et al. “Comparison of results between hook plate fixation and ligament reconstruction for acute unstable acromioclavicular joint dislocation”. CIOS Clinics in Orthopedic Surgery1 (2015): 97-103.
- Berthold DP., et al. “Minimum 10-Year Outcomes After Revision Anatomic Coracoclavicular Ligament Reconstruction for Acromioclavicular Joint Instability”. Orthopaedic Journal of Sports Medicine 9 (2020).
- Beitzel K., et al. “Rotational and translational stability of different methods for direct acromioclavicular ligament repair in anatomic acromioclavicular joint reconstruction”. American Journal of Sports Medicine 9 (2014): 2141-2148.
- Millett PJ., et al. “Two-Year Outcomes after Primary Anatomic Coracoclavicular Ligament Reconstruction”. Arthroscopy - Journal of Arthroscopic and Related Surgery10 (2015): 1962-1973.
- Mazzocca AD., et al. “A biomechanical evaluation of an anatomical coracoclavicular ligament reconstruction”. American Journal of Sports Medicine2 (2006): 236-246.
- Klimkiewicz john J., et al. “The acromioclavicular capsule as a restraint to posterior translation of the clavicle: A biomechanical analysis”. Journal of Shoulder and Elbow Surgery2 (2020): 119-124.
- Tauber M., et al. “Arthroscopic Stabilization of Chronic Acromioclavicular Joint Dislocations: Triple- Versus Single-Bundle Reconstruction”. American Journal of Sports Medicine2 (2016):482-489.
- Taft TN., et al. “Dislocation of the acromioclavicular joint. An end-result study”. The Journal of Bone and Joint Surgery. American Volume 7 (1987): 1045-1051.
- Scheibel M., et al. “Arthroscopically assisted stabilization of acute high-grade acromioclavicular joint separations”. American Journal of Sports Medicine 7 (2011): 1507-1516.
- Wellmann M., et al. “Instabilitätsmuster bei Akromioklavikulargelenkverletzungen vom Typ Rockwood III: Bedeutung der horizontalen Instailität”. Orthopade 4 (2013): 271-277.
- Saier T., et al. “Value of additional acromioclavicular cerclage for horizontal stability in complete acromioclavicular separation: a biomechanical study”. Knee Surgery, Sports Traumatology, Arthroscopy5 (2015): 1498-505.
- Mardani-Kivi M., et al. “Horizontal instability after acromioclavicular joint reduction using the two-hole technique is preferred over the loop technique: a single-blind randomized clinical trial”. Clinics in Shoulder and Elbow 3 (2022): 224-249.
- Borbas P., et al. “High-Strength Suture Tapes Are Biomechanically Stronger Than High-Strength Sutures Used in Rotator Cuff Repair”. Arthroscopy, Sports Medicine, and Rehabilitation 3 (2021): e873-880.
- Walz L., et al. “The anatomic reconstruction of acromioclavicular joint dislocations using 2 Tight Rope devices: A biomechanical study”. American Journal of Sports Medicine12 (2008): 2398-2406.
- Laux CJ., et al. “Stand-alone coracoclavicular suture repair achieves very good results in unstable distal clavicle fractures at a minimum follow-up of 1 year”. Journal of Shoulder and Elbow Surgery 9 (2021): 2090-2096.
Citation
Copyright