Saccomanno Maristella F, Fodale Mario, Capasso Luigi, Cazzato Gianpiero, Milano Giuseppe
Department of Orthopaedics, Catholic University, Division of Orthopaedic Surgery, "A. Gemelli" University Hospital, Rome, Italy.
Joints. 2014 May 8;2(1):6-14. eCollection 2014 Jan-Mar.
this study was conducted to assess the safety and efficacy of a new surgical technique for anatomical reconstruction of the coracoclavicular (CC) and acromioclavicular (AC) ligaments using one single-strand semitendinosus tendon graft.
eighteen patients affected by chronic type III-V AC joint dislocations were included in the present study between January 2010 and March 2012. All underwent the same surgical operation and rehabilitation protocol. The semitendinosus tendon was harvested from the ipsilateral knee. The CC and AC ligaments were reconstructed using the graft passed beneath the coracoid and through bone tunnels in the clavicle and in the acromion. The graft was secured with non-absorbable sutures. Radiographic recurrence of AC joint dislocation was the primary outcome. Clinical outcome was assessed using the DASH score and normalized Constant score. Wilcoxon's signed-rank test was used for comparison between pre- and postoperative results. Significance was set at p ≤ 0.05.
the mean follow-up duration was 26.4±2.3 months (range: 24-30 months). On X-ray evaluation, only two patients (11%) showed asymptomatic recurrence of AC joint instability. Comparison between pre- and postoperative DASH and Constant scores showed significant clinical improvement (p<0.001).
anatomical reconstruction of CC and AC ligaments using an autologous semitendinosus tendon graft for the treatment of AC joint dislocation provided good and reliable clinical and radiological results with a low failure rate at short-term follow-up.
level IV, therapeutic case series.
本研究旨在评估一种使用单股半腱肌腱移植对喙锁（CC）和肩锁（AC）韧带进行解剖重建的新手术技术的安全性和有效性。
2010年1月至2012年3月期间，本研究纳入了18例慢性III - V型肩锁关节脱位患者。所有患者均接受相同的手术操作和康复方案。半腱肌腱取自同侧膝关节。通过将移植物穿过喙突下方并穿过锁骨和肩峰的骨隧道来重建CC和AC韧带。移植物用不可吸收缝线固定。肩锁关节脱位的影像学复发是主要结局。使用DASH评分和标准化的Constant评分评估临床结局。采用Wilcoxon符号秩检验比较术前和术后结果。显著性设定为p≤0.05。
平均随访时间为26.4±2.3个月（范围：24 - 30个月）。X线评估显示，仅2例患者（11%）出现无症状的肩锁关节不稳定复发。术前和术后DASH及Constant评分比较显示临床有显著改善（p<0.001）。
使用自体半腱肌腱移植对CC和AC韧带进行解剖重建治疗肩锁关节脱位，在短期随访中提供了良好且可靠的临床和影像学结果，失败率较低。
IV级，治疗性病例系列。
