Nordin Jonas S, Aagaard Knut E, Lunsjö Karl
Department of Orthopedics , Helsingborg Hospital , Sweden.
Acta Orthop. 2015 Apr;86(2):225-8. doi: 10.3109/17453674.2014.976806. Epub 2014 Oct 17.
Surgical treatment of chronic acromioclavicular joint dislocations is challenging, and no single procedure can be considered to be the gold standard. In 2010, the GraftRope method (Arthrex Inc., Naples, FL) was introduced in a case series of 10 patients, showing good clinical results and no complications. We wanted to evaluate the GraftRope method in a prospective consecutive series.
8 patients with chronic Rockwood type III-V acromioclavicular joint dislocations were treated surgically using the GraftRope method. The patients were clinically evaluated and a CT scan was performed to assess the integrity of the repair.
In 4 of the 8 patients, loss of reduction was seen within the first 6 weeks postoperatively. A coracoid fracture was the reason in 3 cases and graft failure was the reason in 1 case. In 3 of the 4 patients with intact repairs, the results were excellent with no subjective shoulder disability 12 months postoperatively. It was our intention to include 30 patients in this prospective treatment series, but due to the high rate of complications the study was discontinued prematurely. Based on our results and other recent reports, we cannot recommend the GraftRope method as a treatment option for chronic acromioclavicular joint dislocations.
慢性肩锁关节脱位的手术治疗具有挑战性,尚无单一手术方法可被视为金标准。2010年,在一组10例患者的病例系列中引入了GraftRope方法(美国佛罗里达州那不勒斯市的Arthrex公司),显示出良好的临床效果且无并发症。我们希望在前瞻性连续系列研究中评估GraftRope方法。
8例慢性Rockwood III - V型肩锁关节脱位患者采用GraftRope方法进行手术治疗。对患者进行临床评估,并进行CT扫描以评估修复的完整性。
8例患者中有4例在术后6周内出现复位丢失。3例原因是喙突骨折,1例原因是移植物失败。在4例修复完整的患者中,有3例术后12个月结果极佳,无主观肩部功能障碍。我们本打算在这个前瞻性治疗系列中纳入30例患者,但由于并发症发生率高,该研究提前终止。基于我们的结果和其他近期报告,我们不推荐将GraftRope方法作为慢性肩锁关节脱位的治疗选择。