Truly anatomic coracoclavicular ligament reconstruction with 2 Endobutton devices for acute Rockwood type V acromioclavicular joint dislocations

J Shoulder Elbow Surg. 2018 Jun;27(6):e196-e202. doi: 10.1016/j.jse.2017.12.015. Epub 2018 Jan 17.

Abstract

Background: Truly anatomic coracoclavicular ligament reconstruction (TACCR) according to the original insertions is a creative new method for the treatment of severe acromioclavicular separation. This research analyzed the clinical and radiologic results of TACCR in 25 patients with at least 2-year follow-up.

Methods: The study enrolled 25 patients with Rockwood type V acromioclavicular joint dislocations who underwent TACCR using 2 Endobutton (Smith & Nephew Inc., Andover, MA, USA) devices from May 2013 to October 2015. Patients were assessed with clinical and radiologic follow-up at 3, 6, 12, 18, and 24 months postoperatively. The clinical assessments consisted of the visual analog scale and the Constant score. The radiographic evaluations were performed by measurements of the coracoclavicular distance.

Results: The mean follow-up was 34 ± 6.8 months (range, 24-48 months). The visual analog scale and Constant scores revealed significant advancements from 5 ± 0.9 (range, 4-7) and 45 ± 5.6 (range, 30-54) scores preoperatively to 0 ± 0.5 (range, 0-2) and 95 ± 2.9 (range, 91-98) scores at 24 months postoperatively, respectively. The coracoclavicular distance significantly decreased from 23 ± 5.4 mm (range, 16-34 mm) preoperatively to 8 ± 0.9 mm (range, 7-10 mm) at the final follow-up.

Conclusions: TACCR represents a safe, reliable and creative surgical technique that yields good to excellent clinical and radiologic outcomes in the treatment of severe acromioclavicular separation.

Keywords: Acromioclavicular joint dislocations; conoid ligament; coracoclavicular ligaments; original insertions; trapezoid ligament; truly anatomic reconstruction.

MeSH terms

  • Acromioclavicular Joint / diagnostic imaging
  • Acromioclavicular Joint / physiopathology
  • Acromioclavicular Joint / surgery*
  • Adolescent
  • Adult
  • Aftercare
  • Aged
  • Female
  • Humans
  • Joint Dislocations / diagnostic imaging
  • Joint Dislocations / physiopathology
  • Joint Dislocations / surgery*
  • Ligaments, Articular / surgery*
  • Male
  • Middle Aged
  • Pain Measurement
  • Plastic Surgery Procedures / instrumentation*
  • Plastic Surgery Procedures / methods*
  • Postoperative Period
  • Radiology
  • Visual Analog Scale
  • Young Adult