Department of Sporttraumatology - Knee- and Shoulder-Surgery, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Friedberger Landstraße 430, 60389, Frankfurt am Main, Germany.
Department of Trauma and Orthopedic Surgery, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, Frankfurt am Main, Germany.
Knee Surg Sports Traumatol Arthrosc. 2019 Oct;27(10):3168-3179. doi: 10.1007/s00167-017-4717-1. Epub 2017 Sep 18.
The consolidation of the acromioclavicular (AC) and coracoclavicular (CC) ligament complex after arthroscopically assisted stabilization of acute acromioclavicular joint (ACJ) separation is still under consideration.
Fifty-five consecutive patients after arthroscopically assisted double-CC-bundle stabilization within 14 days after acute high-grade ACJ separation were studied prospectively. All patients were clinically analysed preoperatively (FU0) and post-operatively (FU1 = 6 months; FU2 = 12 months). The structural MRI assessments were performed at FU0 (injured ACJ) and at FU2 bilateral (radiologic control group) and assessed separately the ligament thickness and length at defined regions for the conoid, trapezoid and the superior AC ligament.
Thirty-seven patients were assessed after 6.5 months and after 16.0 months. The 16-month MRI analysis revealed for all patients continuous ligament healing for the CC-complex and the superior AC ligament with in the average hypertrophic consolidation compared to the control side. Separate conoid and trapezoid strands (double-strand configuration) were detected in 27 of 37 (73%) patients, and a single-strand configuration was detected in 10 of 37 (27%) patients; both configurations showed similar CCD data. The ligament healing was not influenced by the point of surgery, age at surgery and heterotopic ossification. The clinical outcome was increased (FU0-FU2): Rowe, 47.7-97.0 pts.; TAFT, 3.9-10.6 pts.; NAS , 8.9-1.4 pts. (all P < 0.05).
The arthroscopically assisted double-CC-bundle stabilization within 14 days after acute high-grade ACJ separation showed 16 months after surgery sufficient consolidations of the AC and double-CC ligament complex in 73%.
III, Case series.
关节镜辅助下治疗急性肩锁关节（ACJ）分离后，喙锁（CC）和肩锁韧带复合体的固定仍存在争议。
前瞻性研究了 55 例连续患者，这些患者在急性高分级 ACJ 分离后 14 天内接受了关节镜辅助下双 CC 束固定术。所有患者均在术前（FU0）和术后（FU1=6 个月；FU2=12 个月）进行临床分析。在 FU0（受伤的 ACJ）和 FU2 双侧（放射学对照组）进行结构 MRI 评估，并分别评估在特定区域的喙突、梯形和上 AC 韧带的韧带厚度和长度。
37 例患者在 6.5 个月和 16.0 个月后进行了评估。16 个月的 MRI 分析显示，所有患者的 CC 复合体和上 AC 韧带的韧带均连续愈合，与对照侧相比呈肥厚性愈合。在 37 例患者中有 27 例（73%）检测到单独的喙突和梯形束（双股结构），在 37 例中有 10 例（27%）检测到单股结构；两种结构的 CCD 数据相似。韧带愈合不受手术时间、手术时年龄和异位骨化的影响。临床结果增加（FU0-FU2）：Rowe，47.7-97.0 分；TAFT，3.9-10.6 分；NAS，8.9-1.4 分（均 P<0.05）。
急性高分级 ACJ 分离后 14 天内关节镜辅助双 CC 束固定术显示，16 个月后，73%的患者 AC 和双 CC 韧带复合体有足够的固定。
III，病例系列。
