Ranne Juha O, Kainonen Terho U, Lempainen Lasse L, Kosola Jussi A, Kajander Sami A, Niemi Pekka T
1 Sairaala NEO Turku, Finland.
2 Helsingin Yliopisto Laaketieteellinen tiedekunta, Helsinki, Finland.
Surg Innov. 2018 Jun;25(3):224-229. doi: 10.1177/1553350618756150. Epub 2018 Feb 6.
Several techniques have been introduced to treat acromioclavicular (AC) separation using the semitendinosus tendon as a graft for coracoclavicular (CC) ligament reconstruction. However, the tendon may have been used previously or the patient may not want it harvested. Hence, synthetic tendon transfers have become increasingly popular.
Five patients with chronic AC separations were treated. A synthetic polyurethane urea tendon graft (Artelon Tissue Reinforcement [ATR]) was chosen for its ability to partially transform into connective tissue. The patient follow-up period lasted 45 to 60 months.
The mean preoperative Constant Score increased from 64.8 to 100 postoperatively. The mean preoperative Simple Shoulder Test increased from 7.2 to 12 postoperatively. The mean postoperative increase of the CC distance was 1.5 mm. The mean expansion of the clavicular drill hole from the original was 2.1 mm. According to the postoperative magnetic resonance imaging, the grafts had healed well and the cross-sections of the grafts were up to 10.5 mm between the coracoid and the clavicle.
The synthetic ATR tendon strip was a practical method for reconstructing a torn CC ligament complex. The ATR graft appears promising for future CC ligament reconstructions.
已经引入了几种技术，使用半腱肌腱作为移植物来治疗肩锁关节（AC）分离，以重建喙锁（CC）韧带。然而，该肌腱可能之前已被使用过，或者患者可能不希望采集该肌腱。因此，合成肌腱转移越来越受欢迎。
对5例慢性AC分离患者进行了治疗。选择了一种合成聚氨酯脲肌腱移植物（Artelon组织增强材料[ATR]），因其能够部分转化为结缔组织。患者随访期为45至60个月。
术前Constant评分平均从64.8提高到术后的100分。术前简单肩部测试平均从7.2提高到术后的12分。CC距离术后平均增加1.5毫米。锁骨钻孔的平均扩张比原来增加2.1毫米。根据术后磁共振成像，移植物愈合良好，喙突与锁骨之间移植物的横截面积达10.5毫米。
合成ATR肌腱条是重建撕裂的CC韧带复合体的一种实用方法。ATR移植物在未来CC韧带重建中似乎很有前景。
