- Email: [email protected]
A Randomized Comparative Study of Arthroscopic Fixation in Acute Tossy III Acromioclavicular Joint Dislocation: Single Versus Double Paired Endobutton Loop
2017 ISAKOS ABSTRACTS
Category: Shoulder - Instability Paper #58: A Randomized Comparative Study of Arthroscopic Fixation in Acute Tossy III Acromioclavicular Joint Dislocation: Single Versus Double Paired Endobutton Loop WEI LU, MD, PHD, PROF., CHINA DAPING WANG, CHINA WEIMIN ZHU, MD, CHINA KAN OUYANG, CHINA LIANGQUAN PENG, MD, CHINA HAIFENG LIU, PHD, CHINA HAO LI, MD, CHINA WENZHE FENG, MASTER OF MEDICINE, CHINA JIAN XU, PHD, CHINA MINGJIN ZHONG, MD, CHINA Shenzhen second people’s hospital; Shenzhen 1st affiliated hospital, Shenzhen, Guangdong, CHINA
SUMMARY We made a comparison of single and double paired Endobutton Loop in arthroscopic fixation in acute Tossy III acromioclavicular joint dislocation so as to provide good suggestion to the surgeons. ABSTRACT DATA Background: Tossy III acromioclavicular joint (ACJ) dislocation is a common trauma and needs surgical treatment. However, the better treatment option for this disease is controversial. Purpose: To evaluate and compare the efficacy of two types of the paired loop Endobutton (PLE) plate and thus to provide a better choice for the surgeons. Study design: Case-Control Study. Patients and Methods: A total of 38 patients were assigned to either the single PLE group or the double PLE group (with 19 cases in each group). Radiography of involved shoulder joint and three-dimensional computed tomography scan were obtained in all cases preoperatively. The length and width of both clavicle and coracoid, and the angle between the long axes of clavicle and coracoid, were measured. Outcome evaluation including the indexes of visual analog scale (VAS) for pain, radiography of the involved shoulder, range of shoulder motion and time of return to activities and sports, constant functional score, Karlsson ACJ score were conducted in a minimum of 2 years postoperatively. Results: Preoperative CT scans showed that the width of the coracoid process base and the angle between the coracoid and clavicle long axes allows for guiding the drilling of two bone tunnels in the clavicle and coracoid process. The postoperative imaging showed that the fixation buttons were in proper placement in most cases of both groups and no postoperative fractures were observed. There was a significant difference in terms of sports mode, postoperative Karlsson score (P < 0.05) between the two groups. However, no significant difference was noted between the two groups in mean shoulder VAS pain score, mean time to recover shoulder movements, and mean
e65
Constant functional scores, postoperatively. All patients were satisfied with the final result of their procedures. Conclusion/Clinical Relevance: The double PLE fixation technique is a successful and secure approach in restoring the stability of acute Tossy III acute acromioclavicular joint dislocation. This is the first prospective and comparative study of single PLE versus double PLE techniques. We believe that this technique is a better surgical procedure in treatment of Tossy III acute acromioclavicular joint dislocation.
Category: Shoulder - Instability Paper #59: The Effect of Type II Slap Lesions Repair Technique on the Length of Intratendinous Vascular Supply in Long Head of Biceps Tendon: A Cadaveric Injection Study CHANAKARN PHORNPHUTKUL, MD, THAILAND SIRIPONG TAHWANG, MD, THAILAND JONGKOLNEE SETTAKORN, MD, THAILAND Chiang Mai University, Chiang Mai, THAILAND
SUMMARY Reapiring techniques of SLAP lesion effect the vascular supply of long head of biceps tendon. ABSTRACT DATA Background: Type II superior labrum anterior and posterior (SLAP) lesions are usually treated with arthroscopic SLAP repair. A vascular supply of proximal long head of biceps tendon (LHBT) passes through soft tissue nearby SLAP repair site. Objectives: To evaluate intratendinous vascular supply of proximal LHBT resulting from SLAP repair and compare between each SLAP repair techniques. Methods: Forty-five fresh cadaveric shoulders were divided into 3 major groups: normal, created SLAP and repaired SLAP group. SLAP lesions were repaired using 3 common techniques: two-anchors with simple sutures, oneanchor with double sutures and one-anchor with horizontal mattress suture. Each group had 9 shoulders. India-ink was injected into acromial branch of thoracoacromial artery. Proximal LHBT was resected for histological cross-sectional study. Intratendinous vascular distance was measured and compared between each groups. Results: The vascular supply of proximal LHBT was seen macroscopically at anterodorsal surface. It derived from soft tissue lying anterior to LHBT origin. In normal shoulder, intratendinous vascular distance was 16.92 1.49 mm (95%CI: 15.78-18.06). There was no significant difference between normal shoulder and created SLAP group (P¼0.503). By comparing non-repaired SLAP to each repair technique, the technique using two-anchors with simple sutures showed no significant difference (P¼0.716), while the others showed significant difference disruption of blood supply (P¼0.0002). There was significant difference between each techniques (P¼0.0001). Conclusion: Main vascular supply of proximal LHBT comes from anterior direction. Some techniques of SLAP
Category: Shoulder - Instability Paper #58: A Randomized Comparative Study of Arthroscopic Fixation in Acute Tossy III Acromioclavicular Joint Dislocation: Single Versus Double Paired Endobutton Loop WEI LU, MD, PHD, PROF., CHINA DAPING WANG, CHINA WEIMIN ZHU, MD, CHINA KAN OUYANG, CHINA LIANGQUAN PENG, MD, CHINA HAIFENG LIU, PHD, CHINA HAO LI, MD, CHINA WENZHE FENG, MASTER OF MEDICINE, CHINA JIAN XU, PHD, CHINA MINGJIN ZHONG, MD, CHINA Shenzhen second people’s hospital; Shenzhen 1st affiliated hospital, Shenzhen, Guangdong, CHINA
SUMMARY We made a comparison of single and double paired Endobutton Loop in arthroscopic fixation in acute Tossy III acromioclavicular joint dislocation so as to provide good suggestion to the surgeons. ABSTRACT DATA Background: Tossy III acromioclavicular joint (ACJ) dislocation is a common trauma and needs surgical treatment. However, the better treatment option for this disease is controversial. Purpose: To evaluate and compare the efficacy of two types of the paired loop Endobutton (PLE) plate and thus to provide a better choice for the surgeons. Study design: Case-Control Study. Patients and Methods: A total of 38 patients were assigned to either the single PLE group or the double PLE group (with 19 cases in each group). Radiography of involved shoulder joint and three-dimensional computed tomography scan were obtained in all cases preoperatively. The length and width of both clavicle and coracoid, and the angle between the long axes of clavicle and coracoid, were measured. Outcome evaluation including the indexes of visual analog scale (VAS) for pain, radiography of the involved shoulder, range of shoulder motion and time of return to activities and sports, constant functional score, Karlsson ACJ score were conducted in a minimum of 2 years postoperatively. Results: Preoperative CT scans showed that the width of the coracoid process base and the angle between the coracoid and clavicle long axes allows for guiding the drilling of two bone tunnels in the clavicle and coracoid process. The postoperative imaging showed that the fixation buttons were in proper placement in most cases of both groups and no postoperative fractures were observed. There was a significant difference in terms of sports mode, postoperative Karlsson score (P < 0.05) between the two groups. However, no significant difference was noted between the two groups in mean shoulder VAS pain score, mean time to recover shoulder movements, and mean
e65
Constant functional scores, postoperatively. All patients were satisfied with the final result of their procedures. Conclusion/Clinical Relevance: The double PLE fixation technique is a successful and secure approach in restoring the stability of acute Tossy III acute acromioclavicular joint dislocation. This is the first prospective and comparative study of single PLE versus double PLE techniques. We believe that this technique is a better surgical procedure in treatment of Tossy III acute acromioclavicular joint dislocation.
Category: Shoulder - Instability Paper #59: The Effect of Type II Slap Lesions Repair Technique on the Length of Intratendinous Vascular Supply in Long Head of Biceps Tendon: A Cadaveric Injection Study CHANAKARN PHORNPHUTKUL, MD, THAILAND SIRIPONG TAHWANG, MD, THAILAND JONGKOLNEE SETTAKORN, MD, THAILAND Chiang Mai University, Chiang Mai, THAILAND
SUMMARY Reapiring techniques of SLAP lesion effect the vascular supply of long head of biceps tendon. ABSTRACT DATA Background: Type II superior labrum anterior and posterior (SLAP) lesions are usually treated with arthroscopic SLAP repair. A vascular supply of proximal long head of biceps tendon (LHBT) passes through soft tissue nearby SLAP repair site. Objectives: To evaluate intratendinous vascular supply of proximal LHBT resulting from SLAP repair and compare between each SLAP repair techniques. Methods: Forty-five fresh cadaveric shoulders were divided into 3 major groups: normal, created SLAP and repaired SLAP group. SLAP lesions were repaired using 3 common techniques: two-anchors with simple sutures, oneanchor with double sutures and one-anchor with horizontal mattress suture. Each group had 9 shoulders. India-ink was injected into acromial branch of thoracoacromial artery. Proximal LHBT was resected for histological cross-sectional study. Intratendinous vascular distance was measured and compared between each groups. Results: The vascular supply of proximal LHBT was seen macroscopically at anterodorsal surface. It derived from soft tissue lying anterior to LHBT origin. In normal shoulder, intratendinous vascular distance was 16.92 1.49 mm (95%CI: 15.78-18.06). There was no significant difference between normal shoulder and created SLAP group (P¼0.503). By comparing non-repaired SLAP to each repair technique, the technique using two-anchors with simple sutures showed no significant difference (P¼0.716), while the others showed significant difference disruption of blood supply (P¼0.0002). There was significant difference between each techniques (P¼0.0001). Conclusion: Main vascular supply of proximal LHBT comes from anterior direction. Some techniques of SLAP