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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
Arthrosc Orthop Sports Med 2019;6:9-17
Published online May 1, 2019;  https://doi.org/10.14517/aosm18008
© 2019 Korean Arthroscopy Society and Korean Orthopedic Society for Sports Medicine.

Dohoon Sun, In-Soo Song, Ja-Yeong Yoon, Deukhee Jung

Department of Orthopaedic Surgery, Daejeon Sun General Hospital, Daejeon, Korea
Correspondence to: In-Soo Song, https://orcid.org/0000-0001-7115-3993, Department of Orthopaedic Surgery, Daejeon Sun Hospital, 29 Mokjung-ro, Jung-gu, Daejeon 34811, Korea. Tel: +82-42-220-8220, Fax: +82-42-221-0429, E-mail: mydangjang@naver.com
Received September 12, 2018; Revised January 19, 2019; Accepted January 9, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
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.
Keywords : Coracoid process; Acromioclavicular joint; Clavicle; Suture anchors; Acromion
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