Acromioclavicular joint reconstruction using the LockDown synthetic implant
| Autor: | L. Holder, W. A. Wallace, P. R. P. Rushton, Ignacio Serrano-Pedraza, Jaime Candal-Couto, R. Taranu |
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| Rok vydání: | 2015 |
| Předmět: |
Male
musculoskeletal diseases medicine.medical_treatment Coracoacromial ligament Cadaver medicine Humans Acromioclavicular joint Orthopedics and Sports Medicine Displacement (orthopedic surgery) Arthroplasty Replacement Reduction (orthopedic surgery) business.industry Shoulder Dislocation Prostheses and Implants Anatomy Middle Aged Biomechanical Phenomena medicine.anatomical_structure Acromioclavicular Joint Clavicle Ligament Female Surgery business Cadaveric spasm Conoid tubercle |
| Zdroj: | The Bone & Joint Journal. :1657-1661 |
| ISSN: | 2049-4408 2049-4394 |
| DOI: | 10.1302/0301-620x.97b12.35257 |
| Popis: | Dislocation of the acromioclavicular joint is a relatively common injury and a number of surgical interventions have been described for its treatment. Recently, a synthetic ligament device has become available and been successfully used, however, like other non-native solutions, a compromise must be reached when choosing non-anatomical locations for their placement. This cadaveric study aimed to assess the effect of different clavicular anchorage points for the Lockdown device on the reduction of acromioclavicular joint dislocations, and suggest an optimal location. We also assessed whether further stability is provided using a coracoacromial ligament transfer (a modified Neviaser technique). The acromioclavicular joint was exposed on seven fresh-frozen cadaveric shoulders. The joint was reconstructed using the Lockdown implant using four different clavicular anchorage points and reduction was measured. The coracoacromial ligament was then transferred to the lateral end of the clavicle, and the joint re-assessed. If the Lockdown ligament was secured at the level of the conoid tubercle, the acromioclavicular joint could be reduced anatomically in all cases. If placed medial or 2 cm lateral, the joint was irreducible. If the Lockdown was placed 1 cm lateral to the conoid tubercle, the joint could be reduced with difficulty in four cases. Correct placement of the Lockdown device is crucial to allow anatomical joint reduction. Even when the Lockdown was placed over the conoid tubercle, anterior clavicle displacement remained but this could be controlled using a coracoacromial ligament transfer. Cite this article: Bone Joint J 2015;97-B:1657–61. |
| Databáze: | OpenAIRE |
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