Velasquez Garcia Ausberto, Mendez Magdalena, Abdo Glen
Department of Orthopedic Surgery, Clinica Universidad de Los Andes, Santiago, Chile.
Department of Orthopedic Surgery, Hospital Militar de Santiago, Santiago, Chile.
Arthrosc Tech. 2022 Mar 28;11(4):e687-e695. doi: 10.1016/j.eats.2021.12.025. eCollection 2022 Apr.
Over the course of the years, the topic of optimizing the management of acromioclavicular joint dislocations has gained popularity, remaining a subject of debate. It has been determined that posterior horizontal instability appears to be one of the factors influencing both clinical and radiographic outcomes, postsurgical reconstructions with coracoclavicular techniques. In contrast, the acromioclavicular ligament complex (ACLC) has been experimentally demonstrated to play a crucial role in horizontal translation and rotational stability of the clavicle. Although several strategies have been established, perfect surgical timing, and its potential impact during the healing process, remain poorly defined. Furthermore, appropriate surgical techniques to restore normal acromioclavicular joint kinematics while ensuring an adequate biological environment remain unclear. Due to the existence of multiple features present in acromioclavicular joint reconstruction techniques, an ideal approach involves ACLC and coracoclavicular combination reconstruction, minimal clavicular drilling, and biological enhancement to ensure anatomical reduction and an adequate process of ligament healing. The purpose of this Technical Note is to present a modified surgical technique of the Neviaser procedure. This modified surgical technique combines an all-arthroscopic single tunnel coracoclavicular fixation with the transfer of the coracoacromial ligament to reconstruct the ACLC.
多年来，优化肩锁关节脱位管理的话题越来越受到关注，仍是一个有争议的主题。已确定后方水平不稳定似乎是影响临床和影像学结果的因素之一，采用喙锁技术进行术后重建。相比之下，肩锁韧带复合体（ACLC）已通过实验证明在锁骨的水平平移和旋转稳定性中起关键作用。尽管已经建立了几种策略，但完美的手术时机及其在愈合过程中的潜在影响仍不明确。此外，在确保适当生物环境的同时恢复正常肩锁关节运动学的合适手术技术仍不清楚。由于肩锁关节重建技术存在多种特点，理想的方法包括ACLC和喙锁联合重建、最小化锁骨钻孔以及生物增强，以确保解剖复位和韧带愈合的充分过程。本技术说明的目的是介绍一种改良的Neviaser手术技术。这种改良的手术技术将全关节镜下单隧道喙锁固定与喙肩韧带转移相结合，以重建ACLC。
