Skip to main content
Log in

Coracoid tunnels in open and arthroscopic treatment of acromioclavicular dislocation: an experimental cadaveric study

  • Original Article
  • Published:
MUSCULOSKELETAL SURGERY Aims and scope Submit manuscript

Abstract

Purpose

Treatment of acromioclavicular joint (ACJ) dislocation is not encoded uniquely. Type I and II injuries are usually treated conservatively, while types IV, V and VI surgically. Controversy still exists over the treatment of type III injuries. In the operative approach, there is no agreement on the best surgical technique. Our purpose is to compare the mini-open and arthroscopic approach focusing on the evaluation of the anatomical precision of the coracoid drilling.

Methods

This is a controlled laboratory study. Ten fresh-frozen cadaveric shoulders were randomly assigned to the two techniques in order to compare them. We performed essential surgical gestures to drill the tunnel using MINAR® System (mini-open) and Dog-Bone® (ARTHREX, arthroscopic). The anatomical specimens were then subjected to CT-scan investigation. We statistically evaluated the precision of these two techniques analyzing DICOM files using two parameters. Parameter 1 evaluates the tunnel entry area on the superior side of the coracoid. Parameter 2 describes the orientation of the tunnel.

Results

There are no statistically significant differences (95% confidence level) between arthroscopic and mini-open approach about the precision in the location of the coracoid hole, regarding the entry area (p = 1.00) and the orientation (p = 0.196).

Conclusion

The evidences collected enable the orthopedic surgeon to choose equally between the two techniques in the treatment of AC joint dislocation toward precision.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Tauber M (2013) Management of acute acromioclavicular joint dislocations: current concepts. Archives of Orthop Trauma Surg 133(7):985–995

    Article  Google Scholar 

  2. Spencer EE (2007) Treatment of grade III acromioclavicular joint injuries. Clin Orthop Relat Res 455:38–44

    Article  Google Scholar 

  3. Modi CS, Beazley J, Zywiel MG, Lawrence TM, Veillette CJH (2013) Controversies relating to the management of acromioclavicular joint dislocations. Bone Jt J 95:1595–1602

    Article  Google Scholar 

  4. Nordqvist A, Petersson CJ (1995) Incidence and causes of shoulder girdle injuries in an urban population. J Shoulder Elb Surg 4:107–112

    Article  CAS  Google Scholar 

  5. Jacobs B, Wade PA (1966) Acromioclavicular-joint injury. An end-result study. J Bone Joint Surg Am 48:475–486

    Article  CAS  Google Scholar 

  6. Webb J, Bannister G (1992) Acromioclavicular disruption in first class rugby players. Br J Sports Med 26:247–248

    Article  CAS  Google Scholar 

  7. Tamaoki MJ et al (2010) Surgical versus conservative interventions for treating acromioclavicular dislocation of the shoulder in adults. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD007429

    Article  PubMed  PubMed Central  Google Scholar 

  8. Mouhsine E, Garofalo R, Crevoisier X, Farron A (2003) Grade I and II acromioclavicular dislocations: results of conservative treatment. J Shoulder Elb Surg 12:599–602

    Article  Google Scholar 

  9. De Carli A et al (2015) Acromioclavicular third-degree dislocation: surgical treatment in acute cases. J Orthop Surg Res 10:13

    Article  Google Scholar 

  10. Hootman JM (2004) Acromioclavicular Dislocation: Conservative or Surgical Therapy. J Athl Train 39:10–11

    PubMed  PubMed Central  Google Scholar 

  11. Ceccarelli E et al (2008) Treatment of acute grade III acromioclavicular dislocation: a lack of evidence. J Orthop Traumatol 9:105–108

    Article  CAS  Google Scholar 

  12. Cho C-H et al (2014) Reliability of the classification and treatment of dislocations of the acromioclavicular joint. J Shoulder Elbow Surg 23:665–670

    Article  Google Scholar 

  13. Coale RM, Hollister SJ, Dines JS, Allen AA, Bedi A (2013) Anatomic considerations of transclavicular-transcoracoid drilling for coracoclavicular ligament reconstruction. J Shoulder Elb Surg 22:137–144

    Article  Google Scholar 

  14. Wang LC et al (2015) Biomechanical Evaluation of Coracoid Tunnel Size and Location for Coracoclavicular Ligament Reconstruction. Arthrosc J Arthrosc Relat Surg 31:825–830

    Article  CAS  Google Scholar 

  15. Nowak MD, Sc D, Arciero RA, Mazzocca AD (2012) Biomechanical Evaluation of Effect of Coracoid Tunnel Acromioclavicular Joint Dislocations. YJARS 28:1230–1236

    Google Scholar 

  16. Mara G (2011) Surgical treatment of acromioclavicular dislocation with minimally invasive surgery 25:359–365

    Google Scholar 

  17. Petersen W, Wellmann M, Rosslenbroich S, Zantop T (2010) Minimally invasive acromioclavicular joint reconstruction (MINAR). Oper Orthopädie und Traumatol 22:52–61

    Article  Google Scholar 

  18. Woodmass J et al (2015) Complications following arthroscopic fixation of acromioclavicular separations: a systematic review of the literature. Open Access J Sport Med 6:97

    Google Scholar 

  19. Luis GE, Yong C-K, Singh DA, Sengupta S, Choon DS (2007) Acromioclavicular joint dislocation: a comparative biomechanical study of the palmaris-longus tendon graft reconstruction with other augmentative methods in cadaveric models. J Orthop Surg Res 2:22

    Article  Google Scholar 

  20. Faggiani M, Vasario GP, Mattei L, Calò MJ, Castoldi F (2016) Comparing mini-open and arthroscopic acromioclavicular joint repair: functional results and return to sport. Musculoskelet Surg 100:187–191

    Article  CAS  Google Scholar 

  21. Rios CG, Arciero RA, Mazzocca AD (2007) Anatomy of the Clavicle and Coracoid process for reconstruction of the coracoclavicular ligaments. Am J Sports Med 35:811–817

    Article  Google Scholar 

  22. Defoort S, Verborgt O (2010) Functional and radiological outcome after arthroscopic and open acromioclavicular stabilization using a double-button fixation system. Acta Orthop Belg 76:585–591

    PubMed  Google Scholar 

  23. Taft TN, Wilson FC, Oglesby JW (1987) Dislocation of the acromioclavicular joint. An end-result study. J Bone Jt Surg Am 69:1045–1051

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to M. Faggiani.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Barberis, L., Faggiani, M., Calò, M.J. et al. Coracoid tunnels in open and arthroscopic treatment of acromioclavicular dislocation: an experimental cadaveric study. Musculoskelet Surg 106, 15–19 (2022). https://doi.org/10.1007/s12306-020-00665-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12306-020-00665-9

Keywords

Navigation