Modified Weaver-Dunn procedure versus the use of a synthetic ligament for acromioclavicular joint reconstruction (original) (raw)
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IOSR Journals , 2019
Acromioclavicular joint dislocation corresponds to 8.6% of all joint dislocation. These injuries are associated with contact sports or athletic activity where a direct blow to the lateral aspect of the shoulder occurs. Over last 10 to 15 years there has been increase in the number of publications of the surgical treatment of AC joint with repairs and reconstruction procedures. The rapid progression of orthopaedic implant technology has also led to improved application of surgical techniques. It is clear that a gold standard for surgical stabilization of chronic, painful AC joint dislocations has yet to be established. We report the result of a prospective study of fifteen patients with Rockwood's type III,IV,V,VI AC joint dislocation, treated by Modified Weaver-Dunn procedure.
Shoulder & Elbow, 2019
BackgroundOpinion is divided as to optimum management of grade III acromioclavicular joint injuries that have failed conservative management. We objectively investigated the radiological and functional outcome of acromioclavicular joint reconstruction using the Ligament Augmentation Reconstruction System (LARS®).MethodsRetrospective review of patients with LARS reconstruction of acromioclavicular joint dislocations with minimum six-year follow-up. Functional assessment was performed using the constant score, Disability of Arm Shoulder and Hand score and simple satisfaction score. Radiological assessment was undertaken using plain radiographs. Results were compared with the uninjured limb.ResultsTwenty-four of 25 patients were included. Mean constant score for the injured shoulder was 87.0, Disability of Arm Shoulder and Hand score was 11.6. All patients indicated that they would have the operation again. There were five complications including two patients that suffered small cracks...
Musculoskeletal Surgery, 2016
Introduction Acromioclavicular joint (ACJ) dislocation is a common injury that can result from sports activities. The surgical technique for the treatment of Type III and Type IV injuries, according to the Rockwood classification, remains controversial. The purpose of the study was to determine the functional outcome after minimally invasive and arthroscopic surgery. The mini-open surgery was done with MINAR Ò system, whereas the arthroscopic technique was done with Dog Bone TM Button. Study design Retrospective Cohort study. Methods We reviewed 31 who were surgically treated for acute acromioclavicular dislocation Type III and Type IV (2012-2015). We excluded subjects with chronic dislocation or other injury. We selected 16 patients (average age 37). Half of the sample patients were treated with mini-open surgery with the MINAR Ò system, and the other half of the patients were treated with the Dog Bone arthroscopic technique. The Constant Shoulder Score, the Oxford Shoulder Score, the Simple Shoulder Test and the Subjective Patient Outcome for Return to Sports (SPORTS) score were used to assess functional outcome of the treated shoulder. Results Mean follow-up was 13 months (range 6-27 months). The mean Constant Shoulder Score was 91.10 (range 82.76-96.66), Oxford Shoulder Score was 46.19 (range 42.00-48.00), the Simple Shoulder Test was 10.50 (range 9.00-12.00), and the SPORTS score was 7.88 (range 3-10). There is a statistically significant difference between the sample operated with the mini-open surgery and the group operated with arthroscopic technique. The probability of return to their sport, according to the results of the SPORTS score, was significantly higher for patients treated with the MINAR Ò system (p \ 0.001). However, the objective parameter of Constant scale is statistically better in patients operated by arthroscopic technique (p \ 0.05; p \ 0.001). Conclusion Restoration of ACJ anatomy is the key to a successful therapy. The surgical technique should be personalized. The miny-open surgery and also the arthroscopic surgery are adequate with good clinical results. However, according to the SPORTS score, the patients treated with mini-open surgery returned to their sport with less pain and better performance than those belonging to the other group.
Shoulder & Elbow, 2019
Background A number of surgical techniques for the treatment of acromioclavicular joint separations have been described; however, few have been able to create a strong intra-operative construct that provides minimal joint translation. A biomechanical study was conducted to examine joint translation in an independent acromioclavicular ligament repair. Methods Three variations of a novel independent acromioclavicular ligament repair technique underwent testing using a Sawbones model. The technique involves threading sutures through two acromial bone tunnels in a suture-bridge configuration and anchoring them into the distal clavicle. Three groups of eight specimens underwent reconstruction; group 1 using FiberTape, group 2 using FiberWire and group 3 using FiberTape in a modified (under-over) suture-bridge configuration. Superior, anterior and posterior translation was tested at loads of 10, 20 and 30 N. Results Group 3 repair yielded the least translation in both anterior–posterior a...
Arthroscopic acromioclavicular joint reconstruction using a synthetic ligament device
European Journal of Orthopaedic Surgery & Traumatology, 2011
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Pakistan Journal of Medical and Health Sciences
Background: In orthopedic trauma acromioclavicular joint disruptions are among the most commonly faced injuries that could be due to sports or road traffic accidents. These are injuries in which treatment is always controversial especially in type III of Rockwood type. These injuries accounts for 12% of the total shoulder injuries with young male patients have predominance. Aim: To assess the operational result after acromioclavicular joint fixation with Modified Weaver Dunn procedure using tight roping technique with two endobuttons. Place and duration of study: Department of Orthopedic Surgery, Govt. Shahdrah Teaching Hospital Lahore and Lahore General Hospital Lahore for one year from 01st July 2019 to 30th June 2020. Methodology: This is a descriptive case series study of 10 patients in the combined settings of Department of Orthopedic Surgery Govt. Shahdrah Teaching Hospital Lahore and Lahore General Hospital Lahore. All the cases were operated by a single surgeon using Modifie...
Knee Surgery, Sports Traumatology, Arthroscopy, 2020
Purpose To systematically review the outcomes of surgical treatments of acute acromioclavicular joint dislocation. Methods Studies were identified by electronic databases (Ovid, PubMed). All studies reporting functional and radiological outcomes of surgical treatments of acute acromioclavicular joint dislocations were included. Following data were extracted: authors and year, study design, level of evidence, number of patients, age, classification of acromioclavicular joint dislocation, time to surgery, surgical technique, follow-up, clinical and imaging outcomes, complications, and failures. Descriptive statistics was used, when a data pooling was not possible. Comparable outcomes were pooled to generate summary outcomes reported as frequency-weighted values. Quality appraisal was assessed through the MINORS checklist. Results One hundred and thirty-three studies were included for a total of 4473 shoulders. Mean age of participants was 36.9 years. Mean follow-up was 42.06 months. Arthroscopy showed better ASES (p < 0.0001) and lower VAS pain score (p = 0.0249) compared to an open approach. Biologic and synthetic reconstructions demonstrated better results over osteosynthesis techniques. Biologic techniques showed overall better Constant (p = 0.0001) and DASH (p = 0.0215) scores, while synthetic reconstruction showed better UCLA score (p = 0.0001). Among suture buttons, triple button showed overall better results in Constant (p = 0.0001) and VAS (p = 0.0001) scores, while better results in DASH score (p = 0.0003) were achieved by 2 double button techniques. Overall, the level of evidence was low. Conclusion Biological and synthetic reconstructions achieved better functional scores compared to osteosynthesis. Among suture buttons, the triple button showed better functional performance. Level of evidence IV.
The American journal of sports medicine, 2014
Many reconstructions of acromioclavicular (AC) joint dislocations have focused on the coracoclavicular (CC) ligaments and neglected the functional contribution of the AC ligaments and the deltotrapezial fascia. To compare the modifications of previously published methods for direct AC reconstruction in addition to a CC reconstruction. The hypothesis was that there would be significant differences within the variations of surgical reconstructions. Controlled laboratory study. A total of 24 cadaveric shoulders were tested with a servohydraulic testing system. Two digitizing cameras evaluated the 3-dimensional movement. All reconstructions were based on a CC reconstruction using 2 clavicle tunnels and a tendon graft. The following techniques were used to reconstruct the AC ligaments: a graft was shuttled underneath the AC joint back from anterior and again sutured to the acromial side of the joint (group 1), a graft was fixed intramedullary in the acromion and distal clavicle (group 2)...
Functional Outcome of Modified Weaver Dunn Technique for Acromioclavicular Joint Dislocation
Indian journal of orthopaedics
The debate about the ideal surgical procedure for acromioclavicular joint (ACJ) dislocation is still unresolved and newer techniques are being evolved continuously. The present study evaluates functional outcome of ACJ reconstruction using the modified procedure. 35 patients (26 males, 9 females) with ACJ dislocation, between the age group of 18-48 years (mean age 31 years), were operated using modified procedure at our center from May 2005 to June 2010. The dominant side was involved in 25 patients (22 right, 13 left). The mean period from the time of injury to the surgery was 14 days (range 4-26 days). All the patients were assessed with Oxford shoulder score and the time required to return to preinjury level was recorded. At the mean followup of 95 months (range 72-120 months), the mean Oxford Shoulder Score improved from 25 ± 7.2 to 43 ± 6.9. 85% (30 out of 35) patients had satisfactory results, while 15% (5 out of 35) had mild shoulder dysfunction using this scoring system. Fiv...