Division of Arthroscopy, Joint Surgery and Sport Injuries, Department of Orthopedics, Trauma, and Plastic Surgery, University of Leipzig, Liebigstrasse 20, 04103, Leipzig, Germany.
BMC Musculoskelet Disord. 2021 Jun 9;22(1):528. doi: 10.1186/s12891-021-04406-2.
The purpose of this study was to present a navigated image-free augmentation technique for the acromioclavicular joint (ACJ) and coracoclavicular (CC) ligaments and to report the clinical and radiological outcomes.
From 2013 to 2018, 35 eligible patients were treated with our navigated image-free ACJ- and CC-augmentation technique. The average follow-up was 3 years. Follow-up evaluations included the Constant-Murley Score, subjective shoulder value, Taft score, and the acromioclavicular joint instability (ACJI) score. The patients' quality of life was assessed using the EuroQol-5D (EQ-5D) questionnaire. In addition, in accordance with the instability criteria, radiographs were evaluated before surgery, after surgery, and during follow-up.
Overall, 25 patients (71%) suffered an acute type V disruption, 5 (14%) had a type IV disruption, and 5 (14%) had an acute Rockwood type IIIb injury. The mean Constant-Murley Score was 90 (range: 56-100; p = 0.53) on the injured side, and the mean subjective shoulder value was 92% (range: 80-100%). The mean Taft and ACJI scores were 10 (range: 4-12) and 86 (range: 34-100), respectively and the mean EQ-5D was 86 (range: 2-100). The mean CC difference of the injured side was 4 mm (range: 1.9-9.1 mm) at follow-up, which was not significantly different than that of the healthy side (p = 0.06). No fractures in the area of the clavicle or the coracoid were reported.
The arthroscopic- and navigation-assisted treatment of high-grade ACJ injuries in an anatomical double-tunnel configuration yields similar clinical and radiological outcomes as the conventional technique using an aiming device. Precise positioning of the navigation system prevents multiple drillings, which avoids fractures.
本研究旨在介绍一种用于肩锁关节（ACJ）和喙锁（CC）韧带的无图像导航增强技术，并报告其临床和影像学结果。
2013 年至 2018 年，35 名符合条件的患者接受了我们的导航无图像 ACJ 和 CC 增强技术治疗。平均随访时间为 3 年。随访评估包括 Constant-Murley 评分、主观肩部评分、Taft 评分和肩锁关节不稳定（ACJI）评分。使用 EuroQol-5D（EQ-5D）问卷评估患者的生活质量。此外，根据不稳定标准，在术前、术后和随访时对 X 线片进行评估。
总体而言，25 例（71%）患者为急性 V 型脱位，5 例（14%）为 IV 型脱位，5 例（14%）为急性 Rockwood Ⅲb 型损伤。受伤侧平均 Constant-Murley 评分为 90 分（范围：56-100；p=0.53），平均主观肩部评分为 92%（范围：80-100%）。平均 Taft 和 ACJI 评分为 10 分（范围：4-12）和 86 分（范围：34-100），平均 EQ-5D 评分为 86 分（范围：2-100）。随访时受伤侧 CC 差值平均为 4mm（范围：1.9-9.1mm），与健侧无显著差异（p=0.06）。未报告锁骨或喙突区域有骨折。
关节镜和导航辅助治疗解剖双隧道构型的高级 ACJ 损伤，其临床和影像学结果与使用瞄准器的常规技术相似。导航系统的精确定位可防止多次钻孔，从而避免骨折。
