Complications in AC Joint Stabilization

2019 ◽  
pp. 33-38
Author(s):  
Richard L. Auran ◽  
Evan S. Lederman ◽  
Reuben Gobezie
Keyword(s):  
Ac Joint ◽  
Joint Stabilization

Factors Predicting the Outcome After Arthroscopically Assisted Stabilization of Acute High-Grade Acromioclavicular Joint Dislocations

2019 ◽  
Vol 47 (11) ◽  
pp. 2670-2677 ◽  
Author(s):  
Nina Maziak ◽  
Laurent Audige ◽  
Carmen Hann ◽  
Marvin Minkus ◽  
Markus Scheibel
Keyword(s):  
Clinical Outcome ◽  
Acromioclavicular Joint ◽  
High Grade ◽  
Radiological Outcome ◽  
Ac Joint ◽  
Level Of Evidence ◽  
Outcome Parameters ◽  
Joint Dislocations ◽  
Anatomic Reduction ◽  
Arthroscopically Assisted

Background: Factors influencing the outcome after arthroscopically assisted stabilization of acute high-grade acromioclavicular (AC) joint dislocations remain poorly investigated. Purpose: To identify determinants of the radiological outcome and investigate associations between radiological and clinical outcome parameters. Study Design: Cohort study; Level of evidence, 3. Methods: The authors performed a retrospective analysis of patients who underwent arthroscopically assisted stabilization for acute high-grade AC joint dislocations. The following potential determinants of the radiological outcome were examined using univariable and multivariable regression analyses: timing of surgery, initial AC joint reduction, isolated coracoclavicular (CC) versus combined CC and AC stabilization, ossification of the CC ligaments, age, and overweight status. In addition, associations between radiological (ie, CC difference, dynamic posterior translation [DPT]) and clinical outcome parameters (Subjective Shoulder Value, Taft score [TS] subjective subcategory, and Acromioclavicular Joint Instability Score [ACJI] pain subitem) were evaluated using univariable analysis. Results: One hundred four patients with a mean (±SD) age of 38.1 ± 11.5 years were included in this study. The mean postoperative follow-up was 2.2 ± 0.9 years. Compared with patients with an overreduced AC joint after surgery, the CC difference was 4.3 mm (95% CI, 1.3-7.3; P = .006) higher in patients with incomplete reduction. Patients with anatomic reduction were 3.1 times (95% CI, 1.2-7.9; P = .017) more likely to develop DPT than those with an overreduced AC joint. An incompletely reduced AC joint was 5.3 times (95% CI, 2.1-13.4; P < .001) more likely to develop DPT versus an overreduced AC joint. Patients who underwent isolated CC stabilization were 4.8 times (95% CI, 1.1-21.0; P = .039) more likely to develop complete DPT than patients with additional AC stabilization. Significantly higher CC difference values were noted for patients who reported pain on the subjective TS ( P = .025). Pain was encountered more commonly in patients with DPT ( PTS = .049; PACJI = .038). Conclusion: Clinicians should consider overreduction of the AC joint because it may lead to favorable radiological results. Because of its association with superior radiographic outcomes, consideration should also be given to the use of additional AC cerclage.

scholarly journals The use of the LARS system in the treatment of AC joint instability – Long-term results after a mean of 7.4 years

2018 ◽  
Vol 104 (6) ◽  
pp. 749-754 ◽  
Author(s):  
T.M. Tiefenboeck ◽  
S. Boesmueller ◽  
D. Popp ◽  
S. Payr ◽  
J. Joestl ◽  
...  
Keyword(s):  
Joint Instability ◽  
Long Term Results ◽  
Ac Joint

Management of the Failed AC Joint Reconstruction

2010 ◽  
Vol 18 (3) ◽  
pp. 167-172 ◽  
Author(s):  
Lauren E. Geaney ◽  
Mark D. Miller ◽  
Jonathan B. Ticker ◽  
Anthony A. Romeo ◽  
James J. Guerra ◽  
...  
Keyword(s):  
Ac Joint ◽  
Joint Reconstruction ◽  
Ac Joint Reconstruction

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.

Stabilization of Acute High-Grade Acromioclavicular Joint Separation: A Prospective Assessment of the Clavicular Hook Plate Versus the Double Double-Button Suture Procedure

2018 ◽  
Vol 46 (11) ◽  
pp. 2725-2734 ◽  
Author(s):  
Thomas Stein ◽  
Daniel Müller ◽  
Marc Blank ◽  
Yana Reinig ◽  
Tim Saier ◽  
...  
Keyword(s):  
Constant Score ◽  
Outcome Data ◽  
Hook Plate ◽  
Plate Versus ◽  
High Grade ◽  
Ac Joint ◽  
Level Of Evidence ◽  
Clinical Scores ◽  
Clavicular Hook Plate ◽  
Joint Separation

Background: The stabilization strategy for acute high-grade acromioclavicular (AC) joint separations with AC-stabilizing clavicular hook plate (cHP) or coracoclavicular (CC)–stabilizing double double-button suture (dDBS) is still under consideration. Hypothesis: The CC-stabilizing dDBS is superior to the cHP according to an AC-specific radiologic assessment and score system. Study Design: Cohort study; Level of evidence, 2. Methods: Seventy-three consecutive patients with acute high-grade AC joint separation were prospectively followed in 2 treatment groups (64.4% randomized, 35.6% patient-selected treatment): open reduction and cHP (cHP group) or arthroscopically assisted dDBS (dDBS group) performed within 14 days of injury. Patients were prospectively analyzed by clinical scores (Taft, Constant score [CS], numeric analog scale for pain) and AC-specific radiographs (AC distance, CC distance [CCD], relative CCD [rCCD; 100 / AC distance × CCD]) at points of examination (preoperative and 6, 12, and 24 months). The minimal clinically important differences (MCIDs) were assessed by the anchor-based method. Results: Twenty-seven of 35 patients (mean age ± SD: 37.7 ± 9.7 years) after cHP implantation and 29 of 38 patients (34.2 ± 9.7 years) after dDBS implantation were continuously followed until the 24-month follow-up. All patients showed significantly increased scores after surgery as compared with preoperative status (all P < .05). As compared with GI, GII had significantly better outcomes at 24 months (Taft: cHP = 9.4 ± 1.7 vs dDBS = 10.9 ± 1.1, P < .05, MCID = 2.9; CS: cHP = 90.2 ± 7.8 vs dDBS = 95.3 ± 4.4, P < .02, MCID = 16.6) and at 24 months for Rockwood IV/V (Taft: cHP = 9.4 ± 1.7 vs dDBS = 11.1 ± 0.8, P < .0005; CS: cHP = 90.1 ± 7.7 vs dDBS = 95.5 ± 3.1, P < .04). Clinically assessed horizontal instability persisted in 18.52% (GI) and 6.89% (GII; P = .24). The rCCD showed equal loss of reduction at 24 months (GII = 130.7% [control = 111%] vs GI = 141.8% [control = 115%], MCID = 11.1%). Conclusion: This prospective study showed significantly superior outcomes in all clinical scores between GII and GI. The subanalysis of the high-grade injury type (Rockwood IV/V) revealed that these patients showed significant benefits from the dDBS procedure in the clinical assessments. The cHP procedure resulted in good to excellent clinical outcome data and displayed an alternative procedure for patients needing less restrictive rehabilitation protocols.

Transmural supraspinatus tendon tear caused by suture anchor tip 19-month postacromioclavicular joint stabilisation

2021 ◽  
Vol 14 (7) ◽  
pp. e242511
Author(s):  
Manuel Waltenspül ◽  
Karl Wieser ◽  
Samy Bouaicha
Keyword(s):  
Case Report ◽  
Rotator Cuff ◽  
Suture Anchor ◽  
Supraspinatus Tendon ◽  
Anatomical Location ◽  
Ac Joint ◽  
Tendon Tear ◽  
Paediatric Patients ◽  
Lateral Clavicle ◽  
Rotator Cuff Injuries

Rotator cuff injuries present rarely in paediatric patients due to the tendon strength at this age. There are reports of ruptures caused by either irritation of the lateral clavicle or acromioclavicular (AC) joint in fractures or after usage of hook plates. In this case report, we present a patient with an acute complete supraspinatus rupture caused by a suture anchor tip from a previously performed AC joint stabilisation. After the diagnosis of a new complete supraspinatus, the causative prominent suture anchor was removed, and the tendon subsequently repaired. This case highlights the close anatomic relation of the AC joint and the rotator cuff, which is imperative to adequately address in injuries to this anatomical location.

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