scholarly journals Surface Marking a Helpful Technique in the Approach of Acromioclavicular Joint During Shoulder Arthroscopy

2021 ◽  
Vol 4 (2) ◽  
pp. 02-05
Author(s):  
Munawar Shah ◽  
Usama Bin Saeed ◽  
Mohammed Sufyan ◽  
Danial Shah ◽  
Kishen Parekh
Keyword(s):  
Acromioclavicular Joint ◽  
Shoulder Arthroscopy ◽  
Surface Marking

Bony Edema and Clinical Examination Findings Predict the Need for Distal Clavicle Excision at the Time of Shoulder Arthroscopy

2021 ◽  
pp. 155633162110084
Author(s):  
Conor B. Garry ◽  
Matthew H. Adsit ◽  
Vaughn Land ◽  
Galen Sanderson ◽  
Sean G. Sheppard ◽  
...  
Keyword(s):  
Physical Examination ◽  
Clinical Examination ◽  
Acromioclavicular Joint ◽  
Clinical Symptoms ◽  
Shoulder Arthroscopy ◽  
Binary Logistic Regression ◽  
Distal Clavicle ◽  
Mri Findings ◽  
Binary Logistic Regression Model ◽  
Joint Arthritis

Background: Deciding to perform a distal clavicle excision for acromioclavicular joint arthritis, especially in conjunction with other arthroscopic shoulder procedures, is challenging for surgeons. Studies have reported mixed results on the value of magnetic resonance imaging (MRI) in decision making. Purpose: We sought to correlate MRI findings with clinical symptoms and the surgeon’s decision to perform a distal clavicle excision. Methods: We compared MRI, clinical examination, and MRI findings of 200 patients who underwent distal clavicle excision for symptomatic acromioclavicular joint arthritis with 200 patients who underwent arthroscopic shoulder procedures for other reasons. Univariate statistics were used to determine correlations between physical examination findings, MRI findings, and the decision to perform distal clavicle excision. A binary logistic regression model was used to determine independent predictors of need for distal clavicle excision. Results: There was no difference in mean age, sex, and race between groups. Advanced acromioclavicular joint osteoarthritis was strongly correlated with positive physical examination findings. Bony edema correlated strongly with tenderness at the acromioclavicular joint but not pain with cross-body adduction testing. There was no association between higher MRI grade of osteoarthritis and the need for distal clavicle excision. Regression analysis identified both physical examination findings and bony edema on MRI as independent predictors of the need for distal clavicle excision. Conclusion: In the setting of positive clinical examination findings and bony edema of the distal clavicle, surgeons should feel reassured that distal clavicle excision is likely indicated.

scholarly journals EXPERIENCE IN ARTHROSCOPIC TREATMENT OF ACUTE ACROMIOCLAVICULAR JOINT INJURIES

2018 ◽  
pp. 42-46
Author(s):  
I. V. Grigor’ev ◽  
N. V. Zagorodniy ◽  
F. L. Lazko ◽  
A. P. Prizov ◽  
E. A. Belyak ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Range Of Motion ◽  
Acromioclavicular Joint ◽  
Shoulder Arthroscopy ◽  
Constant Score ◽  
Early Postoperative Period ◽  
Arthroscopic Treatment ◽  
Brachial Plexopathy ◽  
Joint Injuries

Purpose of study: to evaluate surgical treatment results in patients with closed dislocation of the acromial end of the clavicle.Patients and methods. Eighteen patients, aged 23-54 years, with acute acromioclavicular joint injuries of IIIIV type by Rockwood were operated on during 2015 – 2018. Surgical treatment was performed at terms up to 2 weeks after injury. Reduction of the acromial end of the clavicle, arthroscopic fixation and stabilization of acromioclavicular joint by TightRope system was performed. Postoperative follow-up was cjnducted in 4 and 6 weeks, 3 months and subsequently every 6 months after surgical intervention. To evaluate the results the Constant Score and radiographs were used.Results.Follow-up period made up 1 year. Functional result, i.e. range of motion and quality of life, by Constant Score was good already on day 14 after surgery and excellent (89.6±2.9 points) at the end of treatment course (2 months after intervention). Brachial plexopathy (reduction of the thumb and 2nd finger sensitivity and muscular force in the early postoperative period) was observed in 1 case. Six months conservative treatment resulted in positive effect. In 6 months range of motion in the operated joint was equal to that in a healthy one.Conclusion.Arthroscopic treatment of acromioclavicular joint injuries by TightRope system is a highly effective and minimum invasive method but requires experience and practical skills in shoulder arthroscopy.

scholarly journals Experience in arthroscopic treatment of acute acromioclavicular joint injuries

2018 ◽  
Vol 25 (1) ◽  
pp. 42-46
Author(s):  
Igor’ V. Grigor’ev ◽  
N. V Zagorodniy ◽  
F. L Lazko ◽  
A. P Prizov ◽  
E. A Belyak ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Range Of Motion ◽  
Acromioclavicular Joint ◽  
Shoulder Arthroscopy ◽  
Constant Score ◽  
Early Postoperative Period ◽  
Arthroscopic Treatment ◽  
Brachial Plexopathy ◽  
Joint Injuries

Purpose of study: to evaluate surgical treatment results in patients with closed dislocation of the acromial end of the clavicle. Patients and methods. Eighteen patients, aged 23-54 years, with acute acromioclavicular joint injuries of III-IV type by Rockwood were operated on during 2015 - 2018. Surgical treatment was performed at terms up to 2 weeks after injury. Reduction of the acromial end of the clavicle, arthroscopic fixation and stabilization of acromioclavicular joint by TightRope system was performed. Postoperative follow-up was cjnducted in 4 and 6 weeks, 3 months and subsequently every 6 months after surgical intervention. To evaluate the results the Constant Score and radiographs were used. Results. Follow-up period made up 1 year. Functional result, i.e. range of motion and quality of life, by Constant Score was good already on day 14 after surgery and excellent (89.6±2.9 points) at the end of treatment course (2 months after intervention). Brachial plexopathy (reduction of the thumb and 2nd finger sensitivity and muscular force in the early postoperative period) was observed in 1 case. Six months conservative treatment resulted in positive effect. In 6 months range of motion in the operated joint was equal to that in a healthy one. Conclusion. Arthroscopic treatment of acromioclavicular joint injuries by TightRope system is a highly effective and minimum invasive method but requires experience and practical skills in shoulder arthroscopy.

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.

Sign in / Sign up

Export Citation Format

Share Document