A New Coracoclavicular Guider for Minimally Invasive Anatomic Coracoclavicular Reconstruction with Two TightRope Systems in Acute Acromioclavicular Joint Dislocation

Abstract High-grade injuries of complete acromioclavicular (AC) joint disruption (types IV - VI) are typically treated surgically. Since the coracoclavicular (CC) ligament is most often used for stabilizing the AC joint, most reconstruction techniques to treat dislocation of this joint rely upon CC interval fixation. A TightRope system is usually used to augment the CC ligament to treat acute AC dislocations with arthroscopic assistance. The conventional arthroscopic technique employing one TightRope system is associated with some complications, including anterior subluxation of the clavicle and clavicular bony avulsion as a consequence of rotational movements. As an alternative, two TightRope systems can be used to anatomically reconstruct the CC ligament to avoid these complications. We present a new CC guider with which the surgeon can replicate the native CC ligament complex orientation using two TightRope systems via two minimally invasive incisions without arthroscopic assistance. This procedure relies upon the accommodation and stable placement of the clavicle and coracoid bone tunnels for the two TightRope systems in place of the trapezoid and conoid of the CC ligament. We retrospectively reviewed the outcomes for 16 patients with acute dislocation of the AC joint that had been treated by a single surgeon using a double-button fixation system. An independent reviewer conducted functional testing of these patients, including the use of Disability of Arm, Shoulder and Hand (DASH), Constant and visual analog scale (VAS) scores. Standard radiographs were used for assessing the CC distance for the impacted shoulder relative to that of the unaffected contralateral shoulderThe new CC guider leads to an excellent cosmetic result. Our clinical results show that this technique can be easily performed and is similarly invasive to other current arthroscopic techniques.

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

The Bone & Joint Journal ◽

10.1302/0301-620x.102b7.bjj-2020-0114.r1 ◽

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.

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Clinical results of minimally invasive anterolateral THA using a short femoral stem

10.26226/morressier.579b42c4d462b80290b4cbc4 ◽

2016 ◽

Author(s):

Toshie Sasaki

Keyword(s):

Minimally Invasive ◽

Femoral Stem ◽

Clinical Results ◽

Short Femoral Stem

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Microendoscopy-assisted extraforaminal lumbar interbody fusion for treating single-level spondylodesis

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02313-9 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Motohide Shibayama ◽

Guang Hua Li ◽

Li Guo Zhu ◽

Zenya Ito ◽

Fujio Ito

Keyword(s):

Minimally Invasive ◽

Spinal Canal ◽

Interbody Fusion ◽

Facet Joint ◽

Clinical Results ◽

Invasive Technique ◽

Clinical Effects ◽

Lumbar Interbody Fusion ◽

Disc Space ◽

Single Level

Abstract Background Lumbar interbody fusion is a standard technique for treating degenerative lumbar disorders involving instability. Due to its invasiveness, a minimally invasive technique, extraforaminal lumbar interbody fusion (ELIF), was introduced. On surgically approaching posterolaterally, the posterior muscles and spinal canal are barely invaded. Despite its theoretical advantage, ELIF is technically demanding and has not been popularised. Therefore, we developed a microendoscopy-assisted ELIF (mELIF) technique which was designed to be safe and less invasive. Here, we aimed to report on the surgical technique and clinical results. Methods Using a posterolateral approach similar to that of lateral disc herniation surgery, a tubular retractor, 16 or 18 mm in diameter, was placed at the lateral aspect of the facet joint. The facet joint was partially excised, and the disc space was cleaned. A cage and local bone graft were inserted into the disc space. All disc-related procedures were performed under microendoscopy. The spinal canal was not invaded. Bilateral percutaneous screw-rod constructs were inserted and fixed. Results Fifty-five patients underwent the procedure. The Oswestry Disability Index and visual analogue scale scores greatly improved. Over 90% of the patients obtained excellent or good results based on Macnab’s criteria. There were neither major adverse clinical effects nor the need for additional surgery. Conclusions mELIF is minimally invasive because the spinal canal and posterior muscles are barely invaded. It produces good clinical results with fewer complications. This technique can be applied in most single-level spondylodesis cases, including those involving L5/S1 disorders.

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Mid-term clinical results of minimally invasive decompression and posterolateral fusion with percutaneous pedicle screws versus conventional approach for degenerative spondylolisthesis with spinal stenosis

European Spine Journal ◽

10.1007/s00586-011-2114-x ◽

2011 ◽

Vol 21 (6) ◽

pp. 1171-1177 ◽

Cited By ~ 42

Author(s):

Yoshihisa Kotani ◽

Kuniyoshi Abumi ◽

Manabu Ito ◽

Hideki Sudo ◽

Yuichiro Abe ◽

...

Keyword(s):

Minimally Invasive ◽

Spinal Stenosis ◽

Degenerative Spondylolisthesis ◽

Pedicle Screws ◽

Clinical Results ◽

Conventional Approach ◽

Posterolateral Fusion ◽

Minimally Invasive Decompression

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Comparison of Short-Term Clinical Results and Radiologic Changes Between Two Different Minimally Invasive Decompressive Surgical Methods for Lumbar Canal Stenosis

Spine ◽

10.1097/brs.0000000000004052 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Sunao Tanaka ◽

Kanichiro Wada ◽

Gentaro Kumagai ◽

Toru Asari ◽

Shuichi Aburakawa ◽

...

Keyword(s):

Minimally Invasive ◽

Clinical Results ◽

Short Term ◽

Lumbar Canal Stenosis ◽

Canal Stenosis ◽

Surgical Methods

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

Orthopedic Reviews ◽

10.4081/or.2016.6371 ◽

2016 ◽

Vol 8 (2) ◽

Cited By ~ 1

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.

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Minimally Invasive Anterolateral Surgical Approach for Total Hip Arthroplasty: Early Clinical Results

Hip International ◽

10.1177/112070000601604s09 ◽

2006 ◽

Vol 16 (4_suppl) ◽

pp. 42-47 ◽

Cited By ~ 5

Author(s):

H. Röttinger

Keyword(s):

Total Hip Arthroplasty ◽

Minimally Invasive ◽

Hip Arthroplasty ◽

Surgical Approach ◽

Clinical Results ◽

Total Hip

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

10.21203/rs.3.rs-36221/v1 ◽

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.

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Results of a novel surgical technique for iridodialysis repair using segments

10.21203/rs.3.rs-339853/v1 ◽

2021 ◽

Author(s):

Ugur Unsal ◽

Huri Sabur ◽

Mehmet Soyler

Keyword(s):

Surgical Technique ◽

Minimally Invasive ◽

Clinical Results ◽

Study Data ◽

Invasive Technique ◽

Minimally Invasive Surgical ◽

Corrected Distance Visual Acuity ◽

History Of ◽

Surgical Manipulation

Abstract Purpose: To describe a novel surgical technique for iridodialysis repair using iris retractor segments and report its clinical results.Methods: 53 eyes of 53 patients who underwent surgery for iridodialysis repair were enrolled in this retrospective study. Data recorded from patient files consisted of age, sex, history of trauma, surgical indications and type of surgery, preoperative and postoperative corrected distance visual acuity (CDVA), intraocular pressure (IOP), complications, and follow-up time. The novel, minimally invasive surgical technique was explicitly described in detail.Results: Mean follow-up time was 34.4 (range 12-84) months. The subjects were 29 (54.7%) men and 26 (45.3%) women, and the mean age was 56.6±14.0 years. Iridodialysis repair performed using one segment in 37 (69.8%) eyes, two segments in 15 (28.3%) eyes, and three segments in 1 (1.9%) eye. Pupilloplasty was performed in 17 eyes due to wide pupil diameter. The iridodialysis repair was combined with lens removal in 48 eyes, and anterior vitrectomy was performed in 10 eyes. CDVA significantly improved after surgery (p<0.001). Post-traumatic IOP rise was the most common complication, and six patients needed medical therapy for glaucoma control.Conclusion: Iridodialysis repair using iris retractor segment is a minimally invasive technique and found to be safe and effective, providing less surgical manipulation and surgical time than other techniques.

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