Thiago Medeiros Storti, Leony Batista de Paula, Carolina Simionatto, João Eduardo Simionatto, Rafael Salomon Silva Faria, Alexandre Firmino Paniago
Objectives  The present study evaluates and compares the surgical treatment of acute and chronic acromioclavicular dislocations (ACDs) to define the most effective therapeutic plan. Methods  A retrospective study consisting of 30 patients submitted to the surgical treatment of types III and V ACDs between 2011 and 2018; the subjects were separated according to a temporal classification in acute (< 3 weeks; subgroup I) and chronic (> 3 weeks; subgroup II) subgroups. All patients underwent a postsurgical evaluation with a standardized protocol containing epidemiological, functional, and radiological data...
February 2021: Revista Brasileira de Ortopedia
Shimpei Kurata, Kazuya Inoue, Hideo Hasegawa, Takamasa Shimizu, Akio Iida, Kenji Kawamura, Shohei Omokawa, Pasuk Mahakkanukrauh, Yasuhito Tanaka
Background: Acromioclavicular (AC) joint dislocation is evaluated using the radiologically based Rockwood classification. The relationship between ligamentous injury and radiological assessment is still controversial. Purpose/Hypothesis: To investigate how the AC ligament and trapezoid ligament biomechanically contribute to the stability of the AC joint using cadaveric specimens. The hypothesis was that isolated sectioning of the AC ligament would result in increased instability in the superior direction and that displacement >50% of the AC joint would occur...
February 2021: Orthopaedic Journal of Sports Medicine
Ursina Arnet, Wiebe H de Vries, Inge Eriks-Hoogland, Christian Wisianowsky, Lucas H V van der Woude, DirkJan H E J Veeger, Markus Berger
OBJECTIVE: To describe the number, specifics and co-occurrence of shoulder pathologies detected by MRI in manual wheelchair users with spinal cord injury and to evaluate the association between shoulder pathologies and presence of shoulder pain. DESIGN: Cross-sectional observation study. SETTING: Community. PARTICIPANTS: Fifty-one wheelchair-dependent persons with spinal cord injury (44 males, 7 females, median age 50 years (IQR 14), median time since injury 24 years (IQR 16)) were allocated to pain or no-pain group based on the Wheelchair User Shoulder Pain Index...
February 22, 2021: Journal of Spinal Cord Medicine
Eugene Tze Chun Lau, Choon Chiet Hong, Keng Soon Poh, Ruben Manohara, Dennis Zhaowen Ng, Joel Louis Lim, Veerasingam Prem Kumar
BACKGROUND: Controversies for treatment of acromioclavicular joint injuries in particular type III injuries may be partially attributed to the lack of standardized method of radiography and measurement technique. Previous studies looking at the Rockwood classification showed poor inter-observer and intra-observer reliability (Kappa value approximately 0.20 - 0.50). We hypothesized that the use of unilateral instead of bilateral acromioclavicular joints radiographs was the cause of this...
February 11, 2021: Journal of Shoulder and Elbow Surgery
Martin Eigenschink, Philipp R Heuberer, Leo Pauzenberger, Grant E Garrigues, Leonard Achenbach, Sigbjorn Dimmen, Brenda Laky, Lior Laver
PURPOSE: The aim of this review was to compare clinical and radiological outcome of acromio-clavicular joint reconstruction with allografts versus autografts. METHODS: The PubMed, MEDLINE, The Cochrane Library and WEB OF SCIENCE databases were searched in accordance with the PRISMA guidelines until February 2020 using the terms: 'coracoclavicular' OR 'coraco-clavicular' OR 'acromioclavicular' OR 'acromio-clavicular joint', AND 'reconstruction'. All studies reporting on clinical and radiological outcome as well as complications after ACJ reconstruction using allo- and/or autografts were included...
February 10, 2021: Knee Surgery, Sports Traumatology, Arthroscopy
Richard J Murphy, Benedikt Ambuehl, Michael O Schaer, Johannes Weihs, Beat K Moor, Matthias A Zumstein
PURPOSE: The purpose of this study was to evaluate the intermediate-term clinical and radiological outcomes for acute, unstable acromioclavicular joint (ACJ) injuries treated with the arthroscopically assisted BiPOD stabilisation technique. METHODS: Twenty-three patients who sustained acute, unstable ACJ injuries were included in this prospective study. We recorded demographics, injury classification, time to surgery, clinical scores, radiological outcomes and complications; each patient completed a minimum of 2 years post-operative observation...
February 8, 2021: Archives of Orthopaedic and Trauma Surgery
Katsumi Takase, Yukihiko Hata, Yutaka Morisawa, Masafumi Goto, Sakae Tanaka, Junichiro Hamada, Kenji Hayashida, Yasunari Fujii, Toru Morihara, Nobuyuki Yamamoto, Hiroaki Inui, Hiroyuki Shiozaki
Background: Treatment options for acromioclavicular joint (ACJ) separations are highly dependent on severity, as well as the patient's background. Furthermore, some patients can be switched from conservative to surgical treatment. In this study, we conducted a mail-based questionnaire survey of members of the Japan Shoulder Society on the administration of treatments for ACJ separations. Methods: A questionnaire survey with 5 categories was mailed to all 1655 members of the Japan Shoulder Society (including 59 councilors): initial treatment, whether surgery was performed, indications for surgery based on severity, switching from conservative to surgical treatment, and surgical methods...
January 2021: JSES international
Seoyon Yang, Tae Uk Kim, Du Hwan Kim, Min Cheol Chang
The shoulder joint is a ball and socket joint which provides an extensive range of motion. Shoulder pain and weakness are common complaints among patients, which can lead to disability and affect a person's ability to perform daily activities. Shoulder pain and weakness may be associated with shoulder conditions such as rotator cuff disorders adhesive capsulitis, superior labrum anterior to posterior lesions, lesions in the biceps, acromioclavicular joint disease, or instability. Often, a thorough understanding of the network of bony, ligamentous, muscular, and neurovascular anatomy is required to properly identify and diagnose shoulder pathology...
February 2, 2021: Annals of Palliative Medicine
Silvan Beeler, Torsten Pastor, Benjamin Fritz, Lukas Filli, Andreas Schweizer, Karl Wieser
BACKGROUND: Rock climbers are particularly susceptible to shoulder injuries due to repetitive upper-limb movements on vertical or overhanging terrain. However, the long-term effects of prolonged climbing on the shoulder joints are still unknown. PURPOSE: The purpose of this study was to analyze the prevalence of pain and degenerative changes in the shoulder joints after high-level rock climbing over at least 25 years. We hypothesized that specific climber-associated patterns of degeneration would be found...
February 2, 2021: Journal of Shoulder and Elbow Surgery
Yu-Ta Chen, Kuan-Ting Wu, Shun-Wun Jhan, Shan-Ling Hsu, Hao-Chen Liu, Ching-Jen Wang, Jih-Yang Ko, Wen-Yi Chou
BACKGROUND: Acromioclavicular joint (ACJ) dislocation is a relatively common shoulder injury. For the treatment of cases of severe ACJ dislocation (Rockwood type III-V), hook plate fixation is an easy-to-master and minimally-invasive approach to surgical intervention. Over stress on the acromion following hook plate fixation often leads to acromial complications such as osteolysis and loss of reduction. We hypothesized that suspensory reconstruction alongside hook plate fixation might provide a superior stability and reduce complications as compared with hook plate fixation alone...
February 1, 2021: BMC Musculoskeletal Disorders
Fırat Ozan, Sefa Gök, Kürşat Tuğrul Okur, İbrahim Altun, Murat Kahraman, Ali Eray Günay, Kamil Yamak
Background The aim of this study was to evaluate the clinical and radiological results of patients with acute type III Rockwood acromioclavicular joint (ACJ) dislocation treated surgically by employing tension band wiring. Methods The study included 24 patients with traumatic type III ACJ dislocations according to the Rockwood classification. The clinical and radiological outcomes of patients were assessed at the final follow-up visit. Implant failure and reduction loss were assessed using radiographs, whereas the Constant-Murley scoring system was used to assess the patients clinically...
December 21, 2020: Curēus
Andreas Voss, Timon Löffler, Sven Reuter, Andreas B Imhoff, Ralf Kellner, Robert Csapo, Sepp Braun
INTRODUCTION: The current treatment for acromioclavicular (AC) dislocation lacks a gold standard and previous literature concludes that coracoclavicular (CC) fixation with additional AC cerclage fixation adds stability and is a useful adjunct to augment these repairs. AIM: The purpose of this study was to investigate the clinical and radiological value of an additional AC cerclage. It was hypothesised that an additional AC cerclage would show better clinical results...
January 23, 2021: Archives of Orthopaedic and Trauma Surgery
Paul Borbas, Daniele Angelella, Christoph J Laux, Elias Bachmann, Lukas Ernstbrunner, Samy Bouaicha, Karl Wieser
INTRODUCTION: The aim of the present biomechanical study was to evaluate the stability of a novel simple and cost-effective mini-open double cow-hitch suture button technique of acromioclavicular (AC) joint stabilization in comparison to a well-established double tight-rope technique. MATERIALS AND METHODS: A total of 12 fresh-frozen cadaveric shoulders were randomized into two treatment groups. In either a coracoclavicular stabilization with a standard double tight-rope technique (Group 1; n = 6, age 78 years ± 10) or a double cow-hitch with two No...
January 21, 2021: Archives of Orthopaedic and Trauma Surgery
Daniël E Verstift, Iris D Kilsdonk, Marieke F van Wier, Robert Haverlag, Michel P J van den Bekerom
BACKGROUND: Rockwood I and II acromioclavicular joint injuries are generally treated nonoperatively. The long-term outcome is considered to be good but has not yet been properly investigated. PURPOSE: To assess the long-term outcome after nonoperative therapy for Rockwood I and II acromioclavicular joint injuries regarding functional and radiologic outcome. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Eligible patients visited the emergency department between January 2003 and December 2015 and were ≥16 years old at the time of presentation...
January 13, 2021: American Journal of Sports Medicine
Francesc Soler, Fabrizio Mocini, Donald Tedah Djemeto, Stefano Cattaneo, Maristella F Saccomanno, Giuseppe Milano
PURPOSE: To conduct a scoping review to clarify the management of acromioclavicular joint osteoarthritis, as well as to identify any existing gaps in the current knowledge. METHODS: Studies were identified by electronic databases (Ovid, Pubmed) from their inception up to April 2nd, 2020. All studies reporting functional outcomes after conservative or surgical treatment of acromioclavicular joint osteoarthritis, either primary or secondary to trauma or distal clavicle osteolysis, were included...
January 2, 2021: Knee Surgery, Sports Traumatology, Arthroscopy
Jin Tang, Jinzhong Zhao
Disorders of the acromioclavicular (AC) joint quite often necessitate distal clavicle resection (DCR). Arthroscopic DCR is favored because of it is mini-invasive and convenient to treat concomitant intraarticular or subacromial lesions. In previous reports, arthroscopic DCR was performed through the anterior portal with the patient in beach chair position. However, when the patient is in the lateral decubitus position, it is inconvenient to perform DCR through the anterior portal. Thus, we introduce a special DCR technique through the supraspinatus fossa (SSF) portal...
December 2020: Arthroscopy Techniques
Ian S MacLean, Rachel M Frank, Scott W Trenhaile
Acromioclavicular (AC) joint injuries are the most common shoulder injuries in the athletic population. The literature is rife with various surgical techniques and implants as well as opinion on proper timing of surgical options. Patient outcomes are generally similar across fixation method. Complications are common following reconstruction, and the specific type of complication may depend on the technique used. Fracture and graft elongation are associated with use of allograft, whereas button cutout and skin irritation can occur with cortical suture-fixation methods...
December 2020: Arthroscopy Techniques
Ian S MacLean, Rachel M Frank, Scott W Trenhaile
Acromioclavicular (AC) joint injuries are extremely common in the athletic population. Although most low-grade injuries can be managed nonoperatively, high-grade injuries often require reconstruction of the AC joint. Various reconstructive options have been described with varying risks and benefits to each. Implant or graft failure with loss of reduction as well as clavicle and coracoid fracture are a few of the more common complications following AC joint reconstruction surgery. Currently, no gold standard exists...
December 2020: Arthroscopy Techniques
Ralf Kraus, Joern Zwingmann, Manfred Jablonski, M Sinan Bakir
BACKGROUND: Dislocations of the sternoclavicular joint (anterior/posterior) and acromioclavicular joint (SCJ and ACJ, respectively) are rare injuries in childhood/adolescence, each having its own special characteristics. In posterior SCJ dislocation, the concomitant injuries in the upper mediastinum are most important complication, while in anterior SCJ dislocation there is a risk of permanent or recurrent instability. METHODS: In a retrospective analysis from seven pediatric trauma centers under the leadership of the Section of Pediatric Traumatology of the German Trauma Society, children (<18 years) were analyzed with focus on age, gender, trauma mechanism, diagnostics, treatment strategy and follow-up results...
2020: PloS One
Leanne S Blaas, Maayke N van Sterkenburg, Annick M de Planque, Robert J Derksen
Background and hypothesis: The majority of distal clavicle fractures are displaced fractures and constitute a treatment challenge because they have a 30% chance of delayed union or nonunion. Although several options for surgical reconstruction have been described, in patients with a comminuted and/or small distal fragment, these reconstructive options have proved to be prone to failure. Moreover, secondary surgery for removal is necessary in most cases. We hypothesized that the LockDown device, a braided synthetic ligament device, combined with resection of the distal fracture fragment is a suitable alternative in specified patients with distal clavicle fractures...
December 2020: JSES international
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