Dataset Information

Arthroscopically Assisted Double-Loop Suture Repair for Acute Acromioclavicular Joint Disruption.

ABSTRACT: The surgical management of acute high-grade acromioclavicular (AC) joint (ACJ) injuries has evolved during the last decades. Numerous surgical techniques exist and recently arthroscopically assisted or all endoscopic techniques have gained popularity due to certain advantages. The goals of the new anatomic coracoclavicular ligament reconstruction techniques are to achieve anatomic reduction of the ACJ to allow and facilitate primary healing of AC and coracoclavicular (CC) ligaments, and also to minimize the risk of associated complications. We regularly use the open repair with double-loop sutures for the acute ACJ disruption, as described by Dimakopoulos et al. at 2006. In this surgical technique article, we present the arthroscopically assisted technique for the double-loop suture repair.

SUBMITTER: Fandridis EΜ

PROVIDER: S-EPMC9134684 | biostudies-literature | 2022 May

REPOSITORIES: biostudies-literature

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Arthroscopically Assisted Double-Loop Suture Repair for Acute Acromioclavicular Joint Disruption.

Fandridis Emmanouil Μ EΜ Zampeli Frantzeska F Dimakopoulos Panagiotis P

Arthroscopy techniques 20220425 5

The surgical management of acute high-grade acromioclavicular (AC) joint (ACJ) injuries has evolved during the last decades. Numerous surgical techniques exist and recently arthroscopically assisted or all endoscopic techniques have gained popularity due to certain advantages. The goals of the new anatomic coracoclavicular ligament reconstruction techniques are to achieve anatomic reduction of the ACJ to allow and facilitate primary healing of AC and coracoclavicular (CC) ligaments, and also to ...[more]

PMID: 35646578

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Project description:Acromioclavicular (AC) joint injuries occur with a traumatic load to the lateral aspect of the shoulder and account for 9% of all shoulder girdle injuries. Rockwood classified AC joint injuries as type I though type VI, based on severity of injury, radiographic findings, and reducibility of the AC joint. Type I and II injuries are typically managed nonoperatively, whereas type IV, V, and VI are managed operatively to address the significant soft tissue disruption, persistent AC joint instability, and apical shoulder deformation. Treatment of type III injuries remain controversial. Several techniques have been described to treat AC joint injuries with no consensus for optimal treatment. “Anatomic” double-tunnel coracoclavicular ligament reconstruction is one currently popular technique to address AC joint injuries; however, clavicle and coracoid fractures are well-described complications of this technique. The objective of this technical report is to describe our preferred technique to address AC joint injuries. This technique involves using a looped braided polyester prosthetic band and low-profile buckle with allograft augmentation using a device to pass materials around the coracoid process. Technique Video Video 1 Patient with a Grade 4 AC dislocation in beach chair position. AC joint, coracoid, clavicle and planned clavicle incision is marked out. Posterior viewing portal is established and anterior rotator interval portal is used to debride around coracoid. Accessory anterior-inferior portal is established to see the base of the coracoid and resect tissue inferiorly. The open incision over the clavicle is made. This is a chronic case, so the incision is made at lateral edge of the clavicle. Clavipectoral fascia is released to establish pathway under the clavicle. The J-Pass device is loaded with a passing suture. An animated video is shown to explain how the J-Pass device is used to pass suture around the coracoid. The J-Pass is then used to pass a passing suture from medial to lateral around the coracoid. The suture is then passed under the clavicle. The M-Fix and graft are passed under the coracoid and clavicle. The AC joint is reduced, and the M-Fix is provisionally fixed. Reduction is confirmed with arthroscopy. The M-Fix is locked, and the tail is cut. The graft is sutured to itself.

Dataset Information

Arthroscopically Assisted Double-Loop Suture Repair for Acute Acromioclavicular Joint Disruption.

Publications

Arthroscopically Assisted Double-Loop Suture Repair for Acute Acromioclavicular Joint Disruption.

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