Clinical Outcomes in Treatment of Acromioclavicular Joint Dislocation by Synthetic Bonds

Year 2021, , 178 - 184, 30.04.2021

Mehmet Akdemir , Ahmet Çağdaş Biçen , Meric Unal , Mustafa Özkan

https://doi.org/10.47493/abantmedj.2021.49

Abstract

INTRODUCTION: The aim of this study is to evaluate the patients treated with synthetic ligaments due to acromioclavicular joint dislocation and to compare the effects of different ligaments on clinical outcomes.
MATERIALS AND METHODS: Eighteen patients who underwent surgery using synthetic ligaments in our clinic between 2011-2018 due to acute or chronic acromioclavicular joint dislocation were included in the study retrospectively. A total of 18 patients were included in the study. 14 of the patients were male (77.8%) and 4 were female (22.2%). Their average age was 36.5 (19-52). The patients were divided into two groups according to the synthetic bonds that were used. Eleven of the patients were treated with LockDown® (61.1%) and 7 were treated with Tight-rope® (38.9%) system. Clinical outcomes were evaluated according to the Q-DASH scores. Statistical evaluation was made as average, rate, percentage. Mann Whitney-U test was used to evaluate the difference of the averages of the two groups.
RESULTS: The mean follow-up time of the patients was 19.72 months. The overall Q-DASH scores of the patients were 6.94 (0-20.45) on average. In the statistical evaluation, there was no significant difference between the two groups between the Q-DASH scores (p:0.771, p>0.05). Implant failure, clavicle osteolysis and instability in the acromioclavicular joint did not develop in our patients. All patients were able to return to their old jobs.
CONCLUSION: Treatment of acromioclavicular joint dislocations with synthetic ligaments gives good clinical results. However, there is no difference between two different synthetic bonds.

Keywords

Acromioclavicular joint, dislocation, synthetic bond

Akromiyoklaviküler Eklem Dislokasyonunun Sentetik Bağ ile Tedavisinin Klinik Sonuçları

Abstract

GİRİŞ ve AMAÇ: Bu çalışmanın amacı akromiyoklavikuler eklem dislokasyonu nedeniyle sentetik bağlarla tedavi ettiğimiz hastaları değerlendirmek ve farklı bağ seçeneklerinin klinik sonuçlarına etkilerini karşılaştırmaktır.
MATERYAL VE METOD: Kliniğimizde 2011-2018 yılları arasında akut veya kronik akromiyoklaviküler eklem çıkığı nedeniyle sentetik bağ kullanarak cerrahi uyguladığımız 18 hasta retrospektif olarak çalışmaya dahil edildi. Hastaların 14’ü erkek (%77.8), 4’ü kadındı (%22.2), ortalama yaşları 36.5 (19-52) idi. Hastalar kullanılan bağa göre iki gruba ayrıldı. Hastaların 11’i LockDown® (%61.1), 7’si ise Tight-rope® (%38.9) sistemi ile tedavi edilmişlerdi. Hastaların klinik değerlendirilmesi Q-DASH skorlamasına göre yapıldı. İstatistiksel değerlendirme ortalama, oran, yüzde olarak yapıldı. İki grubun ortalamalarının farkını değerlendirmek için Mann Whitney-U testi kullanıldı.
SONUÇLAR: Hastaların ortalama takip süreleri 19.72 aydı. Hastaların genel Q-DASH skorları ortalama 6.94 (0-20.45) idi. Yapılan istatistiksel değerlendirmede iki grup arasında Q-DASH skorları arasında anlamlı fark yoktu (p:0.771, p>0.05). Hastalarımızda implant yetmezliği, clavikula osteolizi ve akromiyoklaviküler eklemde instabilite gelişmedi. Tüm hastalar eski işlerine geri dönebildiler.
ÇIKARIMLAR: Akromiyoklaviküler eklem çıkıklarının sentetik bağlar ile tedavisi klinik olarak iyi sonuçlar vermektedir. Ancak farklı iki sentetik bağ arasında fark yoktur.

Keywords

Akromiyoklaviküler eklem, dislokasyon, sentetik bağ

References

• Kaplan LD, Flanigan DC, Norwig J, Jost P, Bradley J. Prevalence and variance of shoulder injuries in elite collegiate football players. Am J Sports Med. 2005;33(8):1142–46.
• Gastaud O, Raynier JL, Duparc F, et al. Reliability of radiographic measurements for acromioclavicular joint separations. Orthop Traumatol Surg Res. 2015;101(8 Suppl):291–5.
• Mouhsine E, Garofalo R, Crevoisier X, Farron A. Grade I and II acromioclavicular dislocations: results of conservative treatment. J Shoulder Elbow Surg. 2003;12(6):599–602.
• Bradley JP, Elkousy H. Decision making: operative versus nonoperative treatment of acromioclavicular joint injuries. Clin Sports Med. 2003;22(2):277–90.
• Smith TO, Chester R, Pearse EO, Hing CB. Operative versus non-operative management following Rockwood grade III acromioclavicular separation: a meta-analysis of the current evidence base. J Orthop Traumatol. 2011;12(1):19–7.
• Weaver JK, Dunn HK. Treatment of acromioclavicular injuries, especially complete acromioclavicular separation. J Bone Joint Surg Am. 1972;54(6):1187–94.
• Grutter PW, Petersen SA. Anatomical acromioclavicular ligament reconstruction: a biomechanical comparison of reconstructive techniques of the acromioclavicular joint. Am J Sports Med. 2005;33(11):1723–28.
• Michlitsch MG, Adamson GJ, Pink M, Estess A, Shankwiler JA, Lee TQ. Biomechanical comparison of a modified Weaver-Dunn and a free-tissue graft reconstruction of the acromioclavicular joint complex. Am J Sports Med. 2010;38(6):1196–203.
• Jones HP, Lemos MJ, Schepsis AA. Salvage of failed acromioclavicular joint reconstruction using autogenous semitendinosus tendon from the knee. Surgical technique and case report. Am J Sports Med. 2001;29(2):234–37.
• LaPrade RF, Hilger B. Coracoclavicular ligament reconstruction using a semitendinosus graft for failed acromioclavicular separation surgery. Arthroscopy. 2005;21(10):1277.
• Thiel E, Mutnal A, Gilot GJ. Surgical outcome following arthroscopic fixation of acromioclavicular joint disruption with the tightrope device. Orthopedics. 2011;34(7): 267–74.
• Jeon IH, Dewnany G, Hartley R, Neumann L, Wallace WA. Chronic acromioclavicular separation: the medium term results of coracoclavicular ligament reconstruction using braided polyester prosthetic ligament. Injury. 2007;38(11):1247–53.
• Cohen G, Boyer P, Pujol N, Hamida Ferjani B, Massin P, Hardy P. Endoscopically assisted reconstruction of acute acromioclavicular joint dislocation using a synthetic ligament. Outcomes at 12 months. Orthop Traumatol Surg Res. 2011;97(2):145–51.
• Wright J, Osarumwense D, Ismail F, Umebuani Y, Orakwe S. Stabilisation for the disrupted acromioclavicular joint using a braided polyester prosthetic ligament. J Orthop Surg (Hong Kong). 2015;23(2):223–8.
• Vascellari A, Schiavetti S, Battistella G, Rebuzzi E, Coletti N. Clinical and radiological results after coracoclavicular ligament reconstruction for type III acromioclavicular joint dislocation using three different techniques. A retrospective study. Joints. 2015;3(2):54–61.
• Fauci F, Merolla G, Paladini P, Campi F, Porcellini G. Surgical treatment of chronic acromioclavicular dislocation with biologic graft vs synthetic ligament: a prospective randomized comparative study. J Orthop Traumatol. 2013;14(4):283–90.
• Boldin C, Fankhauser F, Ratschek M, Haller-Schober EM. Foreign-body reaction after reconstruction of complete acromioclavicular dislocation using PDS augmentation. J Shoulder Elbow Surg. 2004;13(1):99–100.
• Stewart AM, Ahmad CS. Failure of acromioclavicular reconstruction using Gore-Tex graft due to aseptic foreign-body reaction and clavicle osteolysis: a case report. J Shoulder Elbow Surg. 2004;13(5):558–61.
• Mazzocca AD, Santangelo SA, Johnson ST, Rios CG, Dumonski ML, Arciero RA. A biomechanical evaluation of an anatomical coracoclavicular ligament reconstruction. Am J Sports Med. 2006;34(2):236–46.
• Costic RS, Labriola JE, Rodosky MW, Debski RE. Biomechanical rationale for development of anatomical reconstructions of coracoclavicular ligaments after complete acromioclavicular joint dislocations. Am J Sports Med. 2004;32(8):1929–36.
• Debski RE, Parsons IM 4th, Woo SL, Fu FH. Effect of capsular injury on acromioclavicular joint mechanics. J Bone Joint Surg Am. 2001;83(9):1344–51.