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KMID : 1037920190060010009
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Arthroscopy and Orthopedic Sports Medicine
2019 Volume.6 No. 1 p.9 ~ p.17
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Coracoclavicular ligaments augmentation using 2 suture anchors for acute acromioclavicular joint dislocation: comparison of clinical and radiological outcomes with various methods
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Sun Do-Hoon
Song In-Soo
Yoon Ja-Yeong
Jung Deuk-Hee
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Abstract
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Background: Augmentation with a coracoclavicular (CC) suture sling promotes CC ligament healing, and suture anchors offer sufficient pullout strength. We present a surgical technique for CC ligament augmentation using 2 suture anchors and compare the radiological and clinical results of this technique with the results of other methods.
Methods: A total of 109 patients (109 shoulders) who underwent surgery for acute acromioclavicular (AC) dislocation (Rockwood classification type 5) between October 2004 and February 2016 were enrolled. Modified Phemister procedure with suture anchors (MPS) was performed in 31, modified Phemister procedure with Dacron loops (Mersilene-type; Ethicon) (MPM) was performed in 34, CC augmentation with 2 suture anchors (CCS) was performed in 30, arthroscopic CC augmentation with TightRope® (Arthrex) fixation (ACCT) was performed in 7, and AC fixation with a hook plate (ACH) was performed in 7 cases. Mean patient age was 49.5 years, and mean follow-up period was 28.4 months. CC distance (CCD) and AC distance (ACD) before surgery and at the last follow-up were compared among the procedures. University of California at Los Angeles (UCLA) and American Shoulder and Elbow Surgeons (ASES) scores were used to compare clinical outcomes.
Results: Increases in CCD and ACD between the immediate postoperative and last follow-ups were 1.98 and 2.08 mm with CCS, 2.84 and 3.02 with MPS, 2.01 and 3.04 mm with MPM, 2.15 and 3.47 mm with ACCT, and 3.09 and 3.75 mm with ACH, respectively. Increase in CCD and ACD was the smallest with CCS, but differences among the procedures were not statistically significant. Mean UCLA and ASES scores were 31.2 and 81.2, respectively, but differences among the procedures were not statistically significant.
Conclusion: Increase in CCD and ACD was the smallest with CCS, but differences among the procedures were not statistically significant and reasonable clinical results were achieved without any hardware complications.
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KEYWORD
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Coracoid process, Acromioclavicular joint, Clavicle, Suture anchors, Acromion
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