1445 Portland Ave Suite 201
Rochester, NY 14621
Surgery for acute Grade 3 AC separation
April 24th, 2007
An acute Grade 3 AC separation generally is defined as a superiorly displaced clavicle that follows an injury within 2 months. Historically, these injuries have done poorly with bracing ("Kenny Howard brace") and with surgical intervention.Late reconstructions have been limited to those with pain--either Weaver-Dunn arthroplasties or Mumford procedures.
A new implant from Arthrex has altered the landscape, however,making it feasible to perform a minimally invasive arthroscopic reduction of the AC joint. This technique reduces the AC joint and allows the coracoclavicular ligaments to heal. The implant is called the "tight rope." Early clinical outcome reports appear very satisfactory. Indeed, restoration of anatomy, with little morbidity begs the question--"Why not?"
Related Photos:
Preoperative clinical appearance--note the deformity at the AC joint
Preoperative xray shows superior displacement of the clavicle relative to the acromium
Intraoperative picture of the tightrope device in place
Postoperative xray shows reduction of the AC joint
Postoperative scar after arthroscopic repair
Related Videos:
Preoperative clinical examinationThe tightrope device1.Rotator interval is opened2. Coracoid process is thoroughly exposed Jig is drill is placed between clavicle and coracoid3. Drill exits coracoid4.Wire is passes to deliver tightrope suturesThe tightrope is passed5.Tightrope is passed arthroscopicallyTightrope is secured and knots are tiedFinal arthroscopic view of repairEarly outcome after arthroscopic repair of acute Grade 3 AC separation