Distal Clavicular Augmentation with Acromioclavicular and Coracoclavicular Ligament Reconstruction in the Setting of Iatrogenic Induced Acromioclavicular Instability.

Autor:	Peebles LA; Steadman Philippon Research Institute, Vail, Colorado, U.S.A., Dekker TJ; The Steadman Clinic, Vail, Colorado, U.S.A., Akamefula RA; Steadman Philippon Research Institute, Vail, Colorado, U.S.A., Golijanin P; Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, U.S.A., Grantham WJ; The Steadman Clinic, Vail, Colorado, U.S.A., Provencher MT; Steadman Philippon Research Institute, Vail, Colorado, U.S.A.; The Steadman Clinic, Vail, Colorado, U.S.A.
Jazyk:	angličtina
Zdroj:	Arthroscopy techniques [Arthrosc Tech] 2019 Nov 25; Vol. 8 (12), pp. e1583-e1589. Date of Electronic Publication: 2019 Nov 25 (Print Publication: 2019).
DOI:	10.1016/j.eats.2019.08.013
Abstrakt:	Although chronic pain and dysfunction of the acromioclavicular (AC) joint can reliably be treated with distal clavicle excision, disruption of the local stabilizing ligamentous structures may result in iatrogenic instability of the joint. Iatrogenic AC joint instability is a rare condition caused by over resection of the distal clavicle with unintended injury to the stabilizing ligaments in the treatment of AC joint pain. Addressing postresection instability can prove to be difficult because most reconstruction techniques are intended for patients with traumatic AC joint instability with the goal of creating an anatomically stable joint. However, in the setting of iatrogenic instability, the decreased bone stock of the distal clavicle results in instability of the AC joint, especially in the horizontal plane, and may cause these techniques to fail. Thus, operative management must aim to correct both the osseous and ligamentous deficits responsible for the genesis of this instability. In this Technical Note, we describe bony augmentation of the distal clavicle with an iliac crest bone autograft for chronic iatrogenic acromioclavicular joint instability with concomitant reconstruction of the AC and coracoclavicular ligaments. (© 2019 Published by Elsevier on behalf of the Arthroscopy Association of North America.)
Databáze:	MEDLINE
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