scholarly journals Biomechanical Study on the Treatment of Acromioclavicular Joint Dislocation by Coracoclavicular Ligament Reconstruction With a Novel EndoButton Plate Combined With Suture Anchor

2021 ◽  
Author(s):  
Zhe Song ◽  
Chen Wang ◽  
Na Yang ◽  
Yangjun Zhu ◽  
Kun Zhang ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Acromioclavicular Joint ◽  
Suture Anchor ◽  
Acromioclavicular Joint Dislocation ◽  
Coracoclavicular Ligament ◽  
Joint Dislocation ◽  
Average Load ◽  
Load To Failure ◽  
Group A ◽  
Group B

Abstract Purpose This study aimed to assess the biomechanical stability of a novel internal fixation system of EndoButton plate combined with suture anchor in treating acromioclavicular joint dislocation in the cadaveric specimens. In addition, it provides a new method for the clinical treatment of acromioclavicular joint dislocation. Methods Twelve complete shoulder joint specimens were randomly divided into groups A, B, C, and D (n = 3). Firstly, a quasi-static non-destructive circulation experiment was carried out of coracoclavicular ligament until its function failed. Four different internal fixation materials were used to reduce and fix the acromioclavicular joint. Group A was treated with 3.5 mm clavicular hook locking compression plates, Group B with 5 mm suture anchor Group C with 10 mm Endo-button plate, and Group D with a novel combination of 5 mm suture anchor and 10 mm Endo-button plate. Fluoroscopy was performed to undertake the X-ray of the restored acromioclavicular joint, to evaluate the internal fixation position and acromioclavicular joint reduction. Finally, the shoulder joint was fixed firmly on an electronic universal testing machine (100KN) with a self-made stationary fixture, to conduct a destructive static tensile mechanical test of each specimen vertically at a 100 mm/min load speed. The stress-deformation curve was recorded using a computer connected with the universal mechanical testing machine, and the failure strength and reasons for internal fixation were also recorded. Results The average load-to-failure of the coracoclavicular ligament in groups A, B, C, and D was 373.4 ±0.57 N, 373.6 ±0.62 N, 374.4 ±0.68 N, and 373.9 ±0.15 N, respectively (P>0.05). After internal fixation failure, Group A showed two specimens with clavicular fracture, and one with acromial fracture, with an average load-to-failure of 409.8 ±2.92 N. Group B and D showed three specimens with prolapse of anchor, with average load-to-failure of 293.5 ±4.10 N and 374.2 ±0.40 N, respectively. Group C showed three specimens with basilar coracoid fracture, with average load-to-failure of 373.2 ±2.35 N. Statistical differences existed in the biomechanical load of internal fixation failure among the four groups. Group D was statistically different from Group A and Group B, but not Group C. Conclusion The newly designed EndoButton plate combined with suture anchor for coracoclavicular ligament reconstruction was found to boast simple operation and has high feasibility. Thus it was found effective in the reduction of acromioclavicular joint and treatment of acromioclavicular joint dislocation and fitted the biomechanical characteristics of the acromioclavicular joint.

scholarly journals The influence of different hook tip depths on the treatment of acromioclavicular joint dislocation with clavicular hook plate – a retrospective study

2020 ◽  
Author(s):  
ding xu ◽  
Peng Luo ◽  
Yulong Shi ◽  
Weikang Wang ◽  
Weijun Guo ◽  
...  
Keyword(s):  
Acromioclavicular Joint ◽  
Functional Results ◽  
Hook Plate ◽  
Acromioclavicular Joint Dislocation ◽  
Joint Dislocation ◽  
Clavicular Hook Plate ◽  
Group A ◽  
Joint Reduction ◽  
Group B

Abstract Background The purpose of this study was to research the effect of different hook depths on the efficacy and complications of AC dislocation treatment with hook plate, and to provide valuable reference for clinical treatment.Method We retrospectively analyzed the prospectively collected data from 305 consecutive patients with AC joint dislocation between April 2013 and May 2017 at our institute. We defined〝hook tip depth〞as the position of the hook tip relative to the acromion at the coronal plane. According to the division where the tip of the hook was located, the cases were divided into Group A, Group B, Group C, and D group. All patients were required to conform to regular follow up postoperatively. Dislocation and implant maintenance are assessed by routine shoulder imaging. Functional results were evaluated using Constant-Murley criteria.Results A total of 305 cases were included in follow-up and 27 cases were lost. We used Constant-Murley criteria to evaluate functional results. The score of Group B was significantly higher than group A and group C (P<0.01). For evaluation of acromioclavicular joint reduction, we used CCD in imaging to evaluate. There was significant difference between the three groups. Joint reduction was obtained in all patients. Postoperative infection and hardware failure did not present. There were no fractures of acromion and coracoids process. There were 83 cases of shoulder pain, 93 cases of SIS and 124 cases of subacromial erosion. The incidence of complications in group A was significantly higher than group B and group C.Conclusions The relative position of the hook tip and acromion can significantly affect the efficacy and complications of the clavicular hook plate in the treatment of acromioclavicular joint dislocation. During surgery, we should control the depth of hook tip and try our best to put the tip of the hook into the area of group B to achieve an ideal postoperative effect and avoid the occurrence of various complications.

Anchor moored positioning technique by suture anchor and Endobutton fixation for treatment of acromioclavicular joint dislocation

2019 ◽  
Author(s):  
Pu Ying ◽  
Yingchao Shen ◽  
Qiang Wang
Keyword(s):  
Acromioclavicular Joint ◽  
Suture Anchor ◽  
Radiographic Evaluation ◽  
Acromioclavicular Joint Dislocation ◽  
Joint Dislocation ◽  
Radiographic Outcomes ◽  
Loss Of Reduction ◽  
Surgical Methods ◽  
Positioning Technique ◽  
Rockwood Type Iii

Abstract Background Numerous surgical methods have been used for acromioclavicular joint reconstruction.In this study, we analyzed the clinical and radiographic outcomes of truly anatomic coracoclavicular ligaments reconstruction (TACCR) and truly anatomic acromioclavicular ligaments reconstruction (TAACR) using suture anchor and Endobutton fixation for treatment of acromioclavicular joint dislocation. Methods 48 patients (mean age 49 years) with severe acromioclavicular joint dislocation. The patients were classified as Rockwood type III (n=28), IV (n=3) and V (n=17). All patients were operatively treated using anchor moored positioning technique by suture anchor and Endobutton fixation. Clinical and radiographic evaluation include the visual analog scale (VAS), Constant scores (CS) and American Shoulder and Elbow Surgeons (ASES) scores and radiographic outcomes. Results The mean follow-up was 34 months. The VAS decreased from 5 preoperatively to 0 at 24 months (P < .001). The CS and ASES scores improved from 43, 44 preoperatively to 96, 97 at 24 months separately (P < .001). Meanwhile, 47 patients (97.9%) demonstrated stable anatomical fixation on final postoperative radiographs. Loss of reduction occurred in 1 patient (2.1%), but was not correlated with functional outcome. Conclusions Anchor moored positioning technique with Bi-directional fixations by suture anchor and Endobutton fixation represents a new and reliable treatment of AC joint dislocation.

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