ISAKOS: 2019 Congress in Cancun, Mexico
ISAKOS

2019 ISAKOS Biennial Congress ePoster #1840

 

Acromio-Clavicular Joint Stablization with Dynamic System: Literature Review and Outcomes

Mikhail Ryazantsev, MD, PhD, Moscow RUSSIAN FEDERATION
Dmitrii O. Ilyin, MD, PhD, Moscow, Moscow RUSSIAN FEDERATION
Kirill Rybin, MD, Krasnogorsk, Moscow RUSSIAN FEDERATION
Nina Magnitskaya, MD, PhD, Moscow RUSSIAN FEDERATION
Alexey Logvinov, Moscow RUSSIAN FEDERATION
Andrey Korolev, MD, PhD, Prof., Moscow, Russia RUSSIAN FEDERATION

European Clinic of Sports Traumatology and Orthopaedics (ECSTO), Moscow, RUSSIAN FEDERATION

FDA Status Not Applicable

Summary

We evaluate clinical outcomes of ACJ stabilization after acute clavicle dislocations with dynamic system using two methods - arthroscopy and mini-open technic.

Abstract

Objectives. The aim of the present study was to evaluate clinical outcomes of ACJ stabilization after acute clavicle dislocations with dynamic system using two methods - arthroscopy and mini-open technic.

Material and methods. We performed retrospective analysis of 40 patients (39 male, 1 female) who had distal clavicle stabilization with DogBone (Arthrex) system for the period from 2014 to 2017 years in our clinic. In study group 12 surgery was performed using mini-open technic, 28 under arthroscopy control. The average age in the study group was 32±1.49 years (range 15 - 59 years). For postoperative evaluation we use UCLA, ASES and CSS orthopaedic scales. Median CCD calculated in 23 patient before surgery and 35 patients after surgery. Median CDD in preoperative and postoperative x-ray calculated in 15 patients. Median CTD on postoperative x-ray calculated in 35 patients.

Results. 26 patients were available for follow up, 18 in arthroscopy group and 8 in mini-open. We received good and excellent results in both groups (arthroscopy and mini-open) according to UCLA questionnaire in 100% available cases (26/26). According to ASES questionnaire in mini-open group we receive 25% (2/8) good results and in 75% (6/8) – excellent. In arthroscopy group – 100% of excellent results (18/18). According to CSS questionnaire in mini-open group we receive 38% (3/8) good results and in 62% (5/8) – excellent results. In arthroscopy group – 33% of good results (6/18) and 67% - excellent results (12/18). We haven’t receive satisfied and not satisfied results in both groups according to UCLA, ASES and CSS orthopedic scales. Median CCD before surgery was 15.5 mm (interquartile range 11.9 – 18.3).
Median CCD after surgery was 6.12 mm (interquartile range 4.8 – 8.5).
Decrease of CCD after surgery was statistically significant (p=0,0003).
Median of CTD was 28.9 mm (interquartile range 27 – 32.9). We received statistically significant difference (p=0,0009) between CDD with and without axial load on x-rays. We didn’t received statistically significant difference between two groups (arthroscopy and mini-open).

Conclusion. Acromio-clavicular joint stabilization using dynamic systems is

Method

of choice in case of distal clavicle dislocation. Dynamic system shows good and excellent long-term results after the operation according to the orthopedic scales data. Advantage of dynamic systems is absence of need for metal fixator’s removal. Standard x-rays with and without axial loads in comparison with the contralateral side indicates acromio-clavicular joint injury. It is necessary to continue evaluation of the acromio-clavicular joint stabilization results at longer term. In addition, it is important to know preservation of the distal clavicle reposition using dynamic system in the prolonged period after the operation.