Published in
N°004 - January / February 2020
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Innovations in AC-Joint reconstruction using low-profile implants
By Marvin Minkus (1), Nina Maziak (1), Philipp Moroder (1), Markus Scheibel (1,2) in category SURGICAL TECHNIQUE
(1). Charité-Universitaetsmedizin Berlin, Germany - (2). Schulthess Clinic Zurich, Switzerland / markus.scheibel@charite.de
Introduction
Acromioclavicular (AC) joint dislocations are frequent (1-3). When surgery is indicated, several techniques have been proposed to treat AC dislocation. Especially arthroscopic techniques have been improved and were subject to further development during the last decade (4-6). Pulley-like implants such as TightRope (Arthrex Inc., Naples, Florida) devices are widely used for minimal invasive reconstruction of the AC-joint (7-9). However, loss of reduction especially in the horizontal plane with dynamic posterior translation (DPT) was observed in up to 43% of the patients and seemed to be associated with inferior clinical results (6). Biomechanical studies suggested that an additional acromioclavicular cerclage can reconstruct and stabilize the AC-joint in the horizontal plane (10,11). Current clinical data suggest, that the combined coracoclavicular and acromioclavicular stabilization technique can reduce DPT and leads to satisfying clinical results (7). However, several patients complain about implant irritation due to knot stack and require implant removal. A new low-profile TightRope (Arthrex, Naples, Florida) device aims to diminish this complication and simplify the anatomical reduction process.
Figure 1: Preoperative X-ray using a panorama stress view (a)...Content only available to subscribers