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Komplikationsmanagement in der Versorgung von Verletzungen des Akromioklavikulargelenks

Complication management in treatment of acromioclavicular joint injuries

  • Leitthema
  • Published:
Arthroskopie Aims and scope

Zusammenfassung

Aktuell existieren weit über 100 verschiedene Operationstechniken in der Stabilisierung des Akromioklavikulargelenks (ACG). Im letzten Jahrzehnt ist es hierbei v. a. durch technische Innovationen zu einem deutlichen Zuwachs an arthroskopisch assistierten Techniken gekommen. Nach wie vor bleibt jedoch die postoperative Komplikationsrate nach ACG-Stabilisierungen hoch. Zu den häufigsten Komplikationen gehören Repositionsverlust, technisches Versagen, Frakturen, persistierende horizontale Instabilität, Infektionen sowie die postoperative Schultersteife. Bei Auftreten von therapierelevanten Komplikationen ist eine detaillierte Fehleranalyse von hoher Bedeutung, um Aussagen über Bohrkanallage, Anzahl sowie Durchmesser treffen zu können. Im Fall einer Revision ist eine arthroskopisch assistierte Hybridtechnik mit biologischer Augmentation zu empfehlen, um die biomechanischen Gelenkeigenschaften wiederherzustellen.

Abstract

In the currently available literature more than 100 different surgical techniques are described for stabilization of the acromioclavicular joint (ACJ). In the last decade the use of arthroscopically assisted techniques has risen dramatically with the continuous evolution of innovative surgical techniques; however, postoperative complications, such as loss of reduction, technical failures, fractures, persisting horizontal instability, infections and shoulder stiffness remain high. The occurrence of treatment relevant complications necessitates a thorough failure analysis in order to be able to make decisions about the position, number and diameter of bore tunnels. In cases of revision an arthroscopically assisted hybrid technique with biological augmentation is recommended for restoration of biomechanical joint properties.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, University of Connecticut, Farmington, USA

    D. P. Berthold, L. N. Muench & A. D. Mazzocca

  2. Abteilung und Poliklinik für Sportorthopädie, Klinikum rechts der Isar, Technische Universität München, München, Deutschland

    D. P. Berthold, L. N. Muench, F. Dyrna, K. Beitzel &  A. Voss

  3. Klinik für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsklinikum Münster, Münster, Deutschland

    F. Dyrna

  4. Schulterchirurgie, Arthroskopie und Sportorthopädie, ATOS Orthoparc Klinik, Köln, Deutschland

    K. Beitzel

  5. Klinik für Unfallchirurgie, Universitätsklinik Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland

    A. Voss

  6. Sporthopaedicum Straubing-Regensburg, Straubing, Deutschland

    A. Voss

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  1. D. P. Berthold
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Correspondence to A. Voss.

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Interessenkonflikt

A.D. Mazzocca erhält Beraterhonorar und Forschungsgelder von Arthrex Inc. K. Beitzel erhält Beraterhonorarvon Arthrex Inc. Die University of Connecticut (Farmington, USA) erhält Forschungsgelder von Arthrex Inc. Die Firma Arthrex Inc. hatte keinen Einfluss auf die Erstellung des Manuskriptes. D.P. Berthold, L.N. Muench, F. Dyrna und A. Voss geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Berthold, D.P., Muench, L.N., Dyrna, F. et al. Komplikationsmanagement in der Versorgung von Verletzungen des Akromioklavikulargelenks. Arthroskopie 33, 171–175 (2020). https://doi.org/10.1007/s00142-020-00361-7

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  • DOI: https://doi.org/10.1007/s00142-020-00361-7

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