Skip to main content
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 6/2012

01.06.2012 | Shoulder

Acromioclavicular motion after surgical reconstruction

verfasst von: Pierorazio Motta, Laura Bruno, Alberto Maderni, Piermario Tosco, Umberto Mariotti

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 6/2012

Einloggen, um Zugang zu erhalten

Abstract

Purpose

A retrospective long-term study was carried out to determine whether there was any correlation between the clinical motion of the acromioclavicular joint evaluated by a test we set up using 90° of abduction and 0° of external rotation against resistance [90°/0°RTest] and the cross arm test (compared to the healthy side) and full return to everyday activities after surgical repair.

Methods

A clinical and radiographic evaluation was carried out on 51/80 subjects at a 5.4-year mean follow-up, treated for acromioclavicular joint dislocation with an extra-articular artificial loop, between 2000 and 2006.

Results

The 25 subjects with ossifications obtained a normal acromioclavicular joint motion, on both the horizontal and vertical planes. There was a correlation between the normal motion of the reconstructed acromioclavicular joint (compared to the healthy side) in these 25 patients and full clinical recovery, whilst there was no correlation between the Constant score, the simple shoulder test, the radiographic evaluation on one hand and the clinical motion of the joint on the other. Two patients had recurrent dislocation. Three had mobilization of the screws without reduction loss, or negative clinical outcome.

Conclusions

A postoperative radiographic evaluation should be correlated with a clinical evaluation of the acromioclavicular joint motion (normal, hypermobile, unstable). Normal acromioclavicular joint motion was observed in subjects who developed significant ossifications. The study shows that the clinical evaluation of acromioclavicular joint motion is a simple and trustworthy method to assess the clinical result of a surgical repair.

Level of evidence

Diagnostic study investigating a diagnostic test, Level III.
Literatur
1.
Zurück zum Zitat Bannister GC, Wallace WA, Stableforth PG, Hutson MA (1989) The management of acute acromioclavicular dislocation. A randomised prospective controlled trial. J Bone Joint Surg Br 71:848–850PubMed Bannister GC, Wallace WA, Stableforth PG, Hutson MA (1989) The management of acute acromioclavicular dislocation. A randomised prospective controlled trial. J Bone Joint Surg Br 71:848–850PubMed
2.
Zurück zum Zitat Bradley JP, Elkousy H (2003) Decision making: operative versus nonoperative treatment of acromioclavicular joint injuries. Clin Sports Med 22:277–290PubMedCrossRef Bradley JP, Elkousy H (2003) Decision making: operative versus nonoperative treatment of acromioclavicular joint injuries. Clin Sports Med 22:277–290PubMedCrossRef
3.
Zurück zum Zitat Calvo E, Lopez-Franco M, Arribas IM (2006) Clinical and radiologic outcomes of surgical and conservative treatment of type III acromioclavicular joint injury. J Should Elb Surg 15:300–305CrossRef Calvo E, Lopez-Franco M, Arribas IM (2006) Clinical and radiologic outcomes of surgical and conservative treatment of type III acromioclavicular joint injury. J Should Elb Surg 15:300–305CrossRef
4.
Zurück zum Zitat Colosimo AJ, Hummer CD, Heidt RS (1996) Aseptic foreign body reaction to Dacron graft material used for coracoclavicular ligament reconstruction after type III acromioclavicular dislocation. Am J Sports Med 24:561–563PubMedCrossRef Colosimo AJ, Hummer CD, Heidt RS (1996) Aseptic foreign body reaction to Dacron graft material used for coracoclavicular ligament reconstruction after type III acromioclavicular dislocation. Am J Sports Med 24:561–563PubMedCrossRef
5.
Zurück zum Zitat Costic R, Labriola J, Rodosky M, Debski R (2004) Biomechanical rationale for development of anatomical reconstructions of coracoclavicular ligaments after complete acromioclavicular joint dislocations. Am J Sports Med 32:1929–1936PubMedCrossRef Costic R, Labriola J, Rodosky M, Debski R (2004) Biomechanical rationale for development of anatomical reconstructions of coracoclavicular ligaments after complete acromioclavicular joint dislocations. Am J Sports Med 32:1929–1936PubMedCrossRef
6.
Zurück zum Zitat Culp L, Romani W (2006) Physical therapist examination, evaluation, and intervention following the surgical reconstruction of a grade III acromioclavicular joint separation. Phys Ther 86:857–869PubMed Culp L, Romani W (2006) Physical therapist examination, evaluation, and intervention following the surgical reconstruction of a grade III acromioclavicular joint separation. Phys Ther 86:857–869PubMed
7.
Zurück zum Zitat Dawson PA, Adamson GJ, Pink MM, Kornswiet M, Lin S, Shankwiler JA et al (2009) Relative contribution of acromioclavicular joint capsule and coracoclavicular ligaments to acromioclavicular stability. J Should Elb Surg 18:237–244CrossRef Dawson PA, Adamson GJ, Pink MM, Kornswiet M, Lin S, Shankwiler JA et al (2009) Relative contribution of acromioclavicular joint capsule and coracoclavicular ligaments to acromioclavicular stability. J Should Elb Surg 18:237–244CrossRef
8.
Zurück zum Zitat Debski RE, Parsons IM, Woo SL, Fu FH (2001) Effect of capsular injury on acromioclavicular joint mechanics. J Bone Joint Surg Am 83:1344–1351PubMed Debski RE, Parsons IM, Woo SL, Fu FH (2001) Effect of capsular injury on acromioclavicular joint mechanics. J Bone Joint Surg Am 83:1344–1351PubMed
9.
Zurück zum Zitat Deshmukh AV, Wilson DR, Zilberfarb JL, Perlmutter GS (2004) Stability of acromioclavicular joint reconstruction. Biomechanical testing of various surgical techniques in a cadaveric model. Am J Sports Med 32:1492–1498PubMedCrossRef Deshmukh AV, Wilson DR, Zilberfarb JL, Perlmutter GS (2004) Stability of acromioclavicular joint reconstruction. Biomechanical testing of various surgical techniques in a cadaveric model. Am J Sports Med 32:1492–1498PubMedCrossRef
10.
Zurück zum Zitat Fraser-Moodie JA, Shortt NL, Robinson CM (2008) Injuries to the acromioclavicular joint. J Bone Joint Surg Br 90:697–707PubMedCrossRef Fraser-Moodie JA, Shortt NL, Robinson CM (2008) Injuries to the acromioclavicular joint. J Bone Joint Surg Br 90:697–707PubMedCrossRef
11.
Zurück zum Zitat Fukuda K, Craig EV, An KN, Chao EY (1986) Biomechanical study of the ligamentous system of the acromioclavicular joint. J Bone Joint Surg Am 68:434–440PubMed Fukuda K, Craig EV, An KN, Chao EY (1986) Biomechanical study of the ligamentous system of the acromioclavicular joint. J Bone Joint Surg Am 68:434–440PubMed
12.
Zurück zum Zitat Greiner S, Braunsdorf J, Perka C, Herrmann J, Schefflers S (2008) Mid to long-term result of open acromioclavicular-joint reconstruction using PDS cerclage augmentation. Arch Orthop Trauma Surg 129:735–740PubMedCrossRef Greiner S, Braunsdorf J, Perka C, Herrmann J, Schefflers S (2008) Mid to long-term result of open acromioclavicular-joint reconstruction using PDS cerclage augmentation. Arch Orthop Trauma Surg 129:735–740PubMedCrossRef
13.
Zurück zum Zitat Grutter PW, Petersen SA (2005) Anatomical acromioclavicular ligament reconstruction: a biomechanical comparison of reconstructive techniques of the acromioclavicular jont. Am J Sports Med 33:1723–1728PubMedCrossRef Grutter PW, Petersen SA (2005) Anatomical acromioclavicular ligament reconstruction: a biomechanical comparison of reconstructive techniques of the acromioclavicular jont. Am J Sports Med 33:1723–1728PubMedCrossRef
14.
Zurück zum Zitat Harris RI, Wallace AL, Harper GD, Goldberg JA, Sonnabend DH, Walsh WR (2000) Structural properties of the intact and the reconstructed coracoclavicular ligament complex. Am J Sports Med 28:103–108PubMed Harris RI, Wallace AL, Harper GD, Goldberg JA, Sonnabend DH, Walsh WR (2000) Structural properties of the intact and the reconstructed coracoclavicular ligament complex. Am J Sports Med 28:103–108PubMed
15.
Zurück zum Zitat Hessmann M, Gotzen L, Gehling H (1995) Acromioclavicular reconstruction augmented with polydioxanonsulphate bands. Surgical techniques and results. Am J Sports Med 23:552–556PubMedCrossRef Hessmann M, Gotzen L, Gehling H (1995) Acromioclavicular reconstruction augmented with polydioxanonsulphate bands. Surgical techniques and results. Am J Sports Med 23:552–556PubMedCrossRef
16.
Zurück zum Zitat Iannotti J, Williams G Jr (2007) Disorders of the shoulder: diagnosis and management, 2nd edn. Lippincott Williams & Wilkins, Philadelphia, pp 979–1006 Iannotti J, Williams G Jr (2007) Disorders of the shoulder: diagnosis and management, 2nd edn. Lippincott Williams & Wilkins, Philadelphia, pp 979–1006
17.
Zurück zum Zitat Imatani RJ, Hanlon JJ, Cady GW (1975) Acute, complete acromioclavicular separation. J Bone Joint Surg Am 57:328–332PubMed Imatani RJ, Hanlon JJ, Cady GW (1975) Acute, complete acromioclavicular separation. J Bone Joint Surg Am 57:328–332PubMed
18.
Zurück zum Zitat Jari R, Costic R, Rodosky M, Debski R (2004) Biomechanical function of surgical procedures for acromioclavicular joint dislocations. Arthroscopy 20:237–245PubMedCrossRef Jari R, Costic R, Rodosky M, Debski R (2004) Biomechanical function of surgical procedures for acromioclavicular joint dislocations. Arthroscopy 20:237–245PubMedCrossRef
19.
Zurück zum Zitat Kennedy JC (1968) Complete dislocation of the acromioclavicular joint: 14 years later. J Trauma 8:311–318PubMedCrossRef Kennedy JC (1968) Complete dislocation of the acromioclavicular joint: 14 years later. J Trauma 8:311–318PubMedCrossRef
20.
Zurück zum Zitat Kliemkiewicz JJ, Williams GR, Sher JS, Karduna A, Des Jardins J, Iannotti JP (1999) The acromioclavicular capsule as a restraint to posterior translation of the clavicle: a biomechanical analysis. J Should Elb Surg 8:119–124CrossRef Kliemkiewicz JJ, Williams GR, Sher JS, Karduna A, Des Jardins J, Iannotti JP (1999) The acromioclavicular capsule as a restraint to posterior translation of the clavicle: a biomechanical analysis. J Should Elb Surg 8:119–124CrossRef
21.
Zurück zum Zitat Kwon YW, Iannotti JP (2003). Operative treatment of acromioclavicular joint injuries and results. Clin Sports Med 22:291–300, VI Kwon YW, Iannotti JP (2003). Operative treatment of acromioclavicular joint injuries and results. Clin Sports Med 22:291–300, VI
22.
Zurück zum Zitat Larsen E, Bjerg-Nielsen A, Christensen P (1986) Conservative or surgical treatment of acromioclavicular dislocation. A prospective, controlled, randomized study. J Bone Joint Surg Am 68:552–555PubMed Larsen E, Bjerg-Nielsen A, Christensen P (1986) Conservative or surgical treatment of acromioclavicular dislocation. A prospective, controlled, randomized study. J Bone Joint Surg Am 68:552–555PubMed
23.
Zurück zum Zitat Lee KW, Debski RE, Chen CH, Woo SL, Fu FH (1997) Functional evaluation of the ligaments at the acromioclavicular joint during anteroposterior and superoinferior translation. Am J Sports Med 25:858–862PubMedCrossRef Lee KW, Debski RE, Chen CH, Woo SL, Fu FH (1997) Functional evaluation of the ligaments at the acromioclavicular joint during anteroposterior and superoinferior translation. Am J Sports Med 25:858–862PubMedCrossRef
24.
Zurück zum Zitat Lee SJ, Nicholas SJ, Akizuki KH, McHugh MP, Kremenic IJ, Ben-Avi S (2003) Reconstruction of the coracoclavicular ligaments with tendon grafts. Am J Sports Med 31:648–654PubMed Lee SJ, Nicholas SJ, Akizuki KH, McHugh MP, Kremenic IJ, Ben-Avi S (2003) Reconstruction of the coracoclavicular ligaments with tendon grafts. Am J Sports Med 31:648–654PubMed
25.
Zurück zum Zitat Lemos MJ (1998) The evaluation and treatment of the injured acromioclavicular joint in athletes. Am J Sports Med 26:137–144PubMed Lemos MJ (1998) The evaluation and treatment of the injured acromioclavicular joint in athletes. Am J Sports Med 26:137–144PubMed
26.
Zurück zum Zitat MacDonald PB, Lapointe P (2008) Acromioclavicular and sternoclavicular joint injuries. Orthop Clin North Am 39:535–545PubMedCrossRef MacDonald PB, Lapointe P (2008) Acromioclavicular and sternoclavicular joint injuries. Orthop Clin North Am 39:535–545PubMedCrossRef
27.
Zurück zum Zitat Mazzocca AD, Arciero RA, Bicos J (2007) Evaluation and treatment of acromioclavicular joint injuries. Am J Sports Med 35:316–329PubMedCrossRef Mazzocca AD, Arciero RA, Bicos J (2007) Evaluation and treatment of acromioclavicular joint injuries. Am J Sports Med 35:316–329PubMedCrossRef
28.
Zurück zum Zitat Mazzocca AD, Santangelo SA, Johnson ST et al (2006) A biomechanical evaluation of an anatomical coracoclavicular ligament reconstruction. Am J Sports Med 34:236–246PubMedCrossRef Mazzocca AD, Santangelo SA, Johnson ST et al (2006) A biomechanical evaluation of an anatomical coracoclavicular ligament reconstruction. Am J Sports Med 34:236–246PubMedCrossRef
29.
Zurück zum Zitat McFarland EG, Blivin SJ, Doehring CB, Curl LA, Silberstein C (1997) Treatment of grade III acromioclavicular separations in professional throwing athletes: results of a survey. Am J Orthop 26:771–774PubMed McFarland EG, Blivin SJ, Doehring CB, Curl LA, Silberstein C (1997) Treatment of grade III acromioclavicular separations in professional throwing athletes: results of a survey. Am J Orthop 26:771–774PubMed
30.
Zurück zum Zitat Moneim MS, Balduini FC (1982) Coracoid fracture as a complication of surgical treatment by coracoclavicular tape fixation. Clin Orthop Relat Res 168:133–135PubMed Moneim MS, Balduini FC (1982) Coracoid fracture as a complication of surgical treatment by coracoclavicular tape fixation. Clin Orthop Relat Res 168:133–135PubMed
31.
Zurück zum Zitat Motamedi AR, Blevins FT, Willis MC, McNally TP, Shahinpoor M (2000) Biomechanics of the coracoclavicular ligament complex and augmentations used in its repair and reconstruction. Am J Sports Med 28:380–385PubMed Motamedi AR, Blevins FT, Willis MC, McNally TP, Shahinpoor M (2000) Biomechanics of the coracoclavicular ligament complex and augmentations used in its repair and reconstruction. Am J Sports Med 28:380–385PubMed
32.
Zurück zum Zitat Neault MA, Nuber GW, Marymont JV (1996) Infections after surgical repair of acromioclavicular separations with nonabsorbable tape or suture. J Should Elb Surg 5:477–478CrossRef Neault MA, Nuber GW, Marymont JV (1996) Infections after surgical repair of acromioclavicular separations with nonabsorbable tape or suture. J Should Elb Surg 5:477–478CrossRef
33.
Zurück zum Zitat Nourissat G, Henon A, Debet-Mejean A, Clement P, Dumontier C, Sautet A et al (2007) Three-dimensional computed tomographic scan of the external third of the clavicle. Arthroscopy 23:29–33PubMedCrossRef Nourissat G, Henon A, Debet-Mejean A, Clement P, Dumontier C, Sautet A et al (2007) Three-dimensional computed tomographic scan of the external third of the clavicle. Arthroscopy 23:29–33PubMedCrossRef
34.
Zurück zum Zitat Prokop A, Helling HJ, Andermahr J, Mönig S, Rehm KE (2003) Tossy III injuries of the acromioclavicular joint. In what circumstances is surgery still justified? Personal result and literature review. Orthopäde 32:432–436PubMedCrossRef Prokop A, Helling HJ, Andermahr J, Mönig S, Rehm KE (2003) Tossy III injuries of the acromioclavicular joint. In what circumstances is surgery still justified? Personal result and literature review. Orthopäde 32:432–436PubMedCrossRef
35.
Zurück zum Zitat Rawes ML, Dias JJ (1996) Long-term results of conservative treatment for acromioclavicular dislocation. J Bone Joint Surg Br 78:410–412PubMed Rawes ML, Dias JJ (1996) Long-term results of conservative treatment for acromioclavicular dislocation. J Bone Joint Surg Br 78:410–412PubMed
36.
Zurück zum Zitat Rockwood CA (1996) Injuries to the acromioclavicular joint [Chapter 20]. In: Rockwood CA Jr, Williams GR, Young DC (eds) Rockwood and green’s fractures in adults, 4th edn. Lippincott-Raven Publishers, Philadelphia Rockwood CA (1996) Injuries to the acromioclavicular joint [Chapter 20]. In: Rockwood CA Jr, Williams GR, Young DC (eds) Rockwood and green’s fractures in adults, 4th edn. Lippincott-Raven Publishers, Philadelphia
37.
Zurück zum Zitat Rosenorn M, Pedersen E (1974) A comparison between conservative and operative treatment of acute acromioclavicular dislocation. Acta Orthop Scand 45:50–59PubMedCrossRef Rosenorn M, Pedersen E (1974) A comparison between conservative and operative treatment of acute acromioclavicular dislocation. Acta Orthop Scand 45:50–59PubMedCrossRef
38.
Zurück zum Zitat Schlegel TF, Burks RT, Marcus RL, Dunn HK (2001) A prospective evaluation of untreated acute grade III acromioclavicular separations. Am J Sports Med 29:699–703PubMed Schlegel TF, Burks RT, Marcus RL, Dunn HK (2001) A prospective evaluation of untreated acute grade III acromioclavicular separations. Am J Sports Med 29:699–703PubMed
39.
Zurück zum Zitat Taft TN, Wilson FC, Oglesby JW (1987) Dislocation of the acromioclavicular joint. An end-result study. J Bone Joint Surg Am 69:1045–1051PubMed Taft TN, Wilson FC, Oglesby JW (1987) Dislocation of the acromioclavicular joint. An end-result study. J Bone Joint Surg Am 69:1045–1051PubMed
40.
Zurück zum Zitat Tibone J, Sellers R, Tonino P (1992) Strength testing after third-degree acromioclavicular dislocations. Am J Sports Med 20:328–331PubMedCrossRef Tibone J, Sellers R, Tonino P (1992) Strength testing after third-degree acromioclavicular dislocations. Am J Sports Med 20:328–331PubMedCrossRef
41.
Zurück zum Zitat Tossy JD, Mead NC, Sigmond HM (1963) Acromioclavicular separations: useful and practical classification for treatment. Clin Orthop Relat Res 28:111–119PubMed Tossy JD, Mead NC, Sigmond HM (1963) Acromioclavicular separations: useful and practical classification for treatment. Clin Orthop Relat Res 28:111–119PubMed
42.
Zurück zum Zitat Trieb K, Blahovec H, Brand G, Sabeti M, Dominkus M, Kotz R (2004) In vivo and in vitro cellular ingrowth into a new generation of artificial ligament. Eur Surg Res 36:148–151PubMedCrossRef Trieb K, Blahovec H, Brand G, Sabeti M, Dominkus M, Kotz R (2004) In vivo and in vitro cellular ingrowth into a new generation of artificial ligament. Eur Surg Res 36:148–151PubMedCrossRef
43.
Zurück zum Zitat Wojtys E, Nelson G (1991) Conservative treatment of grade III acromioclavicular dislocations. Clin Orthop Relat Res 268:112–119PubMed Wojtys E, Nelson G (1991) Conservative treatment of grade III acromioclavicular dislocations. Clin Orthop Relat Res 268:112–119PubMed
Metadaten
Titel
Acromioclavicular motion after surgical reconstruction
verfasst von
Pierorazio Motta
Laura Bruno
Alberto Maderni
Piermario Tosco
Umberto Mariotti
Publikationsdatum
01.06.2012
Verlag
Springer-Verlag
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 6/2012
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-011-1627-5

Weitere Artikel der Ausgabe 6/2012

Knee Surgery, Sports Traumatology, Arthroscopy 6/2012 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Sind Frauen die fähigeren Ärzte?

30.04.2024 Gendermedizin Nachrichten

Patienten, die von Ärztinnen behandelt werden, dürfen offenbar auf bessere Therapieergebnisse hoffen als Patienten von Ärzten. Besonders gilt das offenbar für weibliche Kranke, wie eine Studie zeigt.

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.