Vogt Wolfgang, Borchert Gudrun H, Ahmed Norus, Brune Jan C
VOGT-ORTHO Consulting & Development, Gramisch-Partenkirchen Germany.
German Institute for Cell and Tissue Replacement (DIZG, gemeinnützige GmbH), Berlin, Germany.
Shoulder Elbow. 2023 Aug;15(4):411-423. doi: 10.1177/17585732221136863. Epub 2022 Nov 24.
The purpose of this retrospective study was to analyze whether chemically sterilized tendon allografts perform as well as other non-sterilized allografts and autografts as described in the literature for anatomical acromioclavicular joint stabilization for the treatment of Rockwood III-V. Allografts are still described as a factor for higher re-rupture rates.
Retrospective data were collected from 21 acromioclavicular joint stabilizations performed by a single surgeon and performed between 2011 and 2014 using sterilized semitendinosus allografts. The primary endpoints were re-rupture and complication rates. Secondary endpoints were AC-joint stability, pain level, return to work and sport and the range of motion.
No re-ruptures occurred during the mean follow-up time of 33 months. Zero complications occurred directly after surgery, but three complications later than three weeks after surgery. All cases resolved without further surgery. After surgery, stability significantly improved for all patients. Post-surgery, 19 patients had stable acromioclavicular joints and only two patients showed minor instabilities. Range of motion returned to the range of the healthy shoulders for all patients.
Chemically sterilized semitendinosus allograft use for anatomic AC-joint stabilization is equivalent to the use of other allografts or autografts and required no hardware removal. No donor age or graft size dependence was observed, due to zero re-ruptures.
本回顾性研究的目的是分析化学消毒的肌腱同种异体移植物是否与文献中描述的用于解剖学肩锁关节稳定以治疗Rockwood III - V型损伤的其他未消毒同种异体移植物和自体移植物表现相同。同种异体移植物仍被描述为再断裂率较高的一个因素。
回顾性收集了由一名外科医生在2011年至2014年间使用消毒的半腱肌同种异体移植物进行的21例肩锁关节稳定手术的数据。主要终点是再断裂和并发症发生率。次要终点是肩锁关节稳定性、疼痛程度、恢复工作和运动情况以及活动范围。
在平均33个月的随访时间内未发生再断裂。术后即刻未发生并发症，但术后三周后发生了3例并发症。所有病例均无需进一步手术即得到解决。术后，所有患者的稳定性均显著改善。术后，19例患者的肩锁关节稳定，只有2例患者表现出轻微不稳定。所有患者的活动范围均恢复到健康肩部的范围。
化学消毒的半腱肌同种异体移植物用于解剖学肩锁关节稳定与使用其他同种异体移植物或自体移植物相当，且无需取出内固定物。由于再断裂率为零，未观察到供体年龄或移植物大小的依赖性。
