Post-operative results in acromioclavicular joint dislocation using the LockDown synthetic implant: A retrospective case series
Keywords:
Acromioclavicular dislocation, acromioclavicular reconstruction, LockDown system, Quality of life, joint reconstructionAbstract
Background: Dislocation of the acromioclavicular joint is a common injury with a number of surgical interventions being described for its treatment. Among the different techniques developed, the LockDown synthetic implant (previously called the Nottingham Surgilig) is a synthetic ligament which has been increasingly used in the ACJ reconstruction with encouraging results.
Aim: To assess the post-operative results in patients who underwent acromioclavicular joint reconstruction using the LockDown system as well as measuring the radiographic appearance in the post-operative radiograph. Patients with a minimum 2year follow up were included in the study.
Materials and Methods: A retrospective case series evaluating 30 patients undergoing ACJ reconstruction with the LockDown system with at least two years of follow up. The clinical assessment was conducted before and after the operation using the Oxford shoulder score and the visual analogue pain score.Types of complications (infection rate, implant failure, bone osteolysis) as well as the radiographic appearance were also noted.
Results: The patients who underwent a Lockdown synthetic implant reconstruction for an acromioclavicular joint dislocation, improved from
24.67±2.35 to 46.8±2.35, p<0.001 in the 2year follow up appointment. According to the Visual Analogue Scale, the pain was reduced significantly from 6.87±0.33 to 1.11±0.22, p<0.001.Complications occurred in 6.6% of the patients, with 2 cases of superficial wound infections.
Conclusion: Patients who underwent a LockDown synthetic implant reconstruction had a significant improvement in their quality of life. From our case series, its widely use is totally justified, making the Lockdown system a valuable tool in the management of acromioclavicular joint dislocations.
Downloads
References
2. Rieser GR,Edwards K,Gould GC, et al.Distal third clavicle fracture fixation: a biomechanical evaluation of fixation.J Shoulder Elbow Surg 2013; 22:848-855.
3. Mouhsine E, Garofalo R, Crevoiser X, et al.Grade I and II acromioclavicular dislocations:results of conservative treatment.J Shoulder Elbow Surg 2003; 12:599-602.
4. Garcia ESJ, Owens BD.Anatomic approach to reconstruction of the unstable acromioclavicular joint.Curr Orthop Pract Jan/Feb 2010; 21:43-48.
5. Smith TO, Chester R, Pearse EO, et al.Operative versus non-operative management following Rockwood grade III acromioclavicular separation:a meta-analysis of the current evidence base.J Orthop Traumatol 2011; 12:19-27.
6. Jeon IH. et al. Chronic acromioclavicular separation: the medium term results of coracoclavicular ligament reconstruction using braided polyester prosthetic ligament. Injury 2007; 38: 1247–53.
7. Carlos AJ, Richards AM, Corbett SA. Stabilization of acromioclavicular joint dislocation using the ‘Surgilig’ technique. Shoulder Elbow 2011; 3: 166–70.
8. Bhattacharya R, Goodchild L, Rangan A. Acromioclavicular joint reconstruction using the Nottingham Surgilig: a preliminary report. Acta Orthop Belg 2008; 74: 167–72.
9. Weaver JK,Dunn HK.Treatment of acromioclavicular injuries, especially complete acromioclavicular separation.J Bone Joint Surg Am1972; 54:1187-1194.
10. Vrgoc G, Japjec M, Jurina P, Gulan G, Jankovic S, Sebecic B, Staresinic M.Operative treatment of acute acromioclavicular dislocations Rockwood III and V- Comparative study between K-wires combined with FiberTape vs. TightRope system.2015 Nov; 46 Suppl 6:S107-12
11. Rajarshi Bhattacharya, Lorna Goodchild, Amar Rangan.Acromioclavicular joint reconstruction using the Nottingham Surgilig: A preliminary report.Acta Orthop.Belg., 2008, 74, 167-172
12. Guheng Wang, Renguo Xie, Tian Mao, Shuguo Xing. Treatment of AC dislocation by reconstructing CC and AC ligaments with allogenic tendons compared with hook plates.J Orthop Surg Res.2018; 13:175.
13. Vinod Kumar, Sunil Garg, Isabel Elzein, Tom Lawrence, Paul Manning,W Angus Wallace. Modified Weaver-Dunn Procedure Versus the Use of a Synthetic Ligament for Acromioclavicular Joint Reconstruction.J Orthop Surg.2014 Aug;22(2): 199-203
14. Barth J, Duparc F, Andrieu K, Duport M, Toussaint B, Bertiaux S, Clavert P, Gastaud O, Brassart N, Beaudouin E, De Mourgues P, Berne D, Bahurel J, Najihi N, Boyer P, Faivre B, Meyer A, Nourissat G, Poulain S, Bruchou F, Menard JF.Is coracoclavicular stabilisation alone sufficient for the endoscopic treatment of severe acromioclavicular joint dislocation(Rockwood type III,IV and V)?2015 Dec; 101(8 Suppl):S297-303.
15. Domos P, Wijeratna M, White A. BESS survey 2013: current concepts in the management of grade III acromioclavicular injuries. 24th Annual Scientific Meeting British Elbow and Shoulder Society Leicester. 5th vol, Wiley 2013:276- 294
16. Nam Hong Choi, Seok Min Lim, Sang Young Lee, Tae Kang Lim.Loss of Reduction and Complications of Coracoclavicular Ligament Reconstruction With Autogenous Tendon Graft in Acute Acromioclavicular Dislocations.J Shoulder Elbow Surg. 2017 Apr;26(4):692-698
17. S.Metzlaff, S. Rosslenbroich, P.H.Forkel, B. Scliemann, H. Arshad, M. Rachke, W. Petersen.Surgical treatment of acute acromioclavicular joint dislocations: hook plate versus minimally invasive reconstruction. Knee surgery Sports Traumatology, Arthroscopy, 24, 1972-1978.
18. Keats TE, Sistrom C. Atlas of Radiologic Measurement. Mosby. (2001) ISBN:0323001610.
19. Alberto Vascellari, Stefano Schiavetti, Giuseppe Battistella, Enrico Rebuzzi, Nicolo Coletti.Clinical and radiological results after coracoclavicular ligament reconstruction for type III acromioclavicular joint dislocation using three different techniques. A retrospective study.Joints. 2015 Apri - Jun;3(2): 54-61.
