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Bedeutung und Behandlung der horizontalen Instabilitätskomponente bei Verletzungen des Akromioklavikulargelenks

Relevance and treatment of the horizontal component in acromioclavicular joint injuries

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Zusammenfassung

Hintergrund

Instabilitäten des Akromioklavikular- (AC-)Gelenks sind nach wie vor eine große Herausforderung. Wachsende Aufmerksamkeit richtet sich auf die dynamische horizontale AC-Gelenkinstabilität. Die Detektierung derselben ist anspruchsvoll und bedient sich einer Mehrzahl von Messmethoden. Zunehmend stehen auch spezielle Techniken zur additiven Stabilisierung des AC-Kapsel-Band-Apparats zur Verfügung.

Ziel

Ziel der nun vorliegenden Arbeit ist es, eine Zusammenfassung des derzeitigen Wissensstands über die horizontale Instabilität des AC-Gelenks zu geben.

Abstract

Background

Instabilities of the acromioclavicular (AC) joint remain a major challenge. Increasing attention is being paid to dynamic, horizontal instabilities of the AC joint. The detection of these instabilities is demanding and requires a variety of quantification methods. More recently, several surgical techniques for AC stabilization have become available.

Aim

The aim of this work is to give an overview over the current state of knowledge regarding horizontal AC joint instabilities.

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Literatur

  1. Barth J, Duparc F, Andrieu K, Duport M, Toussaint B, Bertiaux S et al (2015) Is coracoclavicular stabilisation alone sufficient for the endoscopic treatment of severe acromioclavicular joint dislocation (Rockwood types III, IV, and V)? Orthop Traumatol Surg Res 101:S297–S303

    CAS  PubMed  Google Scholar 

  2. Beitzel K, Cote MP, Apostolakos J, Solovyova O, Judson CH, Ziegler CG et al (2013) Current concepts in the treatment of acromioclavicular joint dislocations. Arthroscopy 29:387–397

    PubMed  Google Scholar 

  3. Beitzel K, Mazzocca AD (2014) Open anatomic reconstruction of chronic acromioclavicular instability. Oper Orthop Traumatol 26:237–244

    CAS  PubMed  Google Scholar 

  4. Beitzel K, Mazzocca AD, Bak K, Itoi E, Kibler WB, Mirzayan R et al (2014) ISAKOS upper extremity committee consensus statement on the need for diversification of the Rockwood classification for acromioclavicular joint injuries. Arthroscopy 30:271–278

    PubMed  Google Scholar 

  5. Beitzel K, Obopilwe E, Apostolakos J, Cote MP, Russell RP, Charette R et al (2014) Rotational and translational stability of different methods for direct acromioclavicular ligament repair in anatomic acromioclavicular joint reconstruction. Am J Sports Med 42:2141–2148

    PubMed  Google Scholar 

  6. Bostrom Windhamre HA, von Heideken JP, Une-Larsson VE, Ekelund AL (2010) Surgical treatment of chronic acromioclavicular dislocations: a comparative study of Weaver-Dunn augmented with PDS-braid or hook plate. J Shoulder Elbow Surg 19:1040–1048

    PubMed  Google Scholar 

  7. Buchholz RW, Heckman JD (2001) Acromioclavicular joint injuries. Rockwood and Green’s fractures in adults. Lippincott Williams & Wilkins, Philadelphia, S 1210–1244

    Google Scholar 

  8. Carofino BC, Mazzocca AD (2010) The anatomic coracoclavicular ligament reconstruction: surgical technique and indications. J Shoulder Elbow Surg 19:37–46

    PubMed  Google Scholar 

  9. Cisneros LN, Reiriz JS (2017) Prevalence of remaining horizontal instability in high-grade acromioclavicular joint injuries surgically managed. Eur J Orthop Surg Traumatol 27:323–333

    PubMed  Google Scholar 

  10. Dawson PA, Adamson GJ, Pink MM, Kornswiet M, Lin S, Shankwiler JA et al (2009) Relative contribution of acromioclavicular joint capsule and coracoclavicular ligaments to acromioclavicular stability. J Shoulder Elbow Surg 18:237–244

    PubMed  Google Scholar 

  11. De Beer J, Schaer M, Latendresse K, Raniga S, Moor BK, Zumstein MA (2017) BiPOD Arthroscopic acromioclavicular repair restores bidirectional stability. Orthopedics 40:e35–e43

    PubMed  Google Scholar 

  12. Deshmukh AV, Wilson DR, Zilberfarb JL, Perlmutter GS (2004) Stability of acromioclavicular joint reconstruction: biomechanical testing of various surgical techniques in a cadaveric model. Am J Sports Med 32:1492–1498

    PubMed  Google Scholar 

  13. Dyrna FGE, Imhoff FB, Voss A, Braun S, Obopilwe E, Apostolakos JM et al (2018) The integrity of the acromioclavicular capsule ensures physiological centering of the acromioclavicular joint under rotational loading. Am J Sports Med 46:1432–1440

    PubMed  Google Scholar 

  14. Emura K, Arakawa T, Miki A, Terashima T (2014) Anatomical observations of the human acromioclavicular joint. Clin Anat 27:1046–1052

    PubMed  Google Scholar 

  15. Fukuda K, Craig EV, An KN, Cofield RH, Chao EY (1986) Biomechanical study of the ligamentous system of the acromioclavicular joint. J Bone Joint Surg Am 68:434–440

    CAS  PubMed  Google Scholar 

  16. Hann C, Kraus N, Minkus M, Maziak N, Scheibel M (2018) Combined arthroscopically assisted coraco- and acromioclavicular stabilization of acute high-grade acromioclavicular joint separations. Knee Surg Sports Traumatol Arthrosc 26:212–220

    PubMed  Google Scholar 

  17. Ibrahim EF, Forrest NP, Forester A (2015) Bilateral weighted radiographs are required for accurate classification of acromioclavicular separation: an observational study of 59 cases. Injury 46:1900–1905

    CAS  PubMed  Google Scholar 

  18. Izadpanah K, Winterer J, Vicari M, Jaeger M, Maier D, Eisebraun L et al (2013) A stress MRI of the shoulder for evaluation of ligamentous stabilizers in acute and chronic acromioclavicular joint instabilities. J Magn Reson Imaging 37:1486–1492

    PubMed  Google Scholar 

  19. Jobmann S, Buckup J, Colcuc C, Roessler PP, Zimmermann E, Schuttler KF et al (2017) Anatomic ligament consolidation of the superior acromioclavicular ligament and the coracoclavicular ligament complex after acute arthroscopically assisted double coracoclavicular bundle stabilization. Knee Surg Sports Traumatol Arthrosc. https://doi.org/10.1007/s00167-017-4717-1

    Article  PubMed  Google Scholar 

  20. Jordan RW, Malik S, Bentick K, Saithna A (2018) Acromioclavicular joint augmentation at the time of coracoclavicular ligament reconstruction fails to improve functional outcomes despite significantly improved horizontal stability. Knee Surg Sports Traumatol Arthrosc. https://doi.org/10.1007/s00167-018-5152-7

    Article  PubMed  Google Scholar 

  21. Kippe MA, Demetropoulos CK, Baker KC, Jurist KA, Guettler JH (2009) Failure of coracoclavicular artificial graft reconstructions from repetitive rotation. Arthroscopy 25:975–982

    PubMed  Google Scholar 

  22. Kraus N, Hann C, Gerhardt C, Scheibel M (2018) Dynamic instability of the acromioclavicular joint: a new classification for acute AC joint separation. Obere Extremität 13:279–285

    PubMed  PubMed Central  Google Scholar 

  23. Kraus N, Scheibel M (2017) Disorders of the acromioclavicular joint. In: Rockwood CA, Matsen FA, Wirth MA, Lippitt SB, Fehringer EV, Sperling JW (Hrsg) Rockwood and Matsen’s The Shoulder, 5. Aufl. Elsevier, Philadelphia, S 447–448

    Google Scholar 

  24. Ladermann A, Grosclaude M, Lubbeke A, Christofilopoulos P, Stern R, Rod T et al (2011) Acromioclavicular and coracoclavicular cerclage reconstruction for acute acromioclavicular joint dislocations. J Shoulder Elbow Surg 20:401–408

    PubMed  Google Scholar 

  25. Li H, Wang C, Wang J, Wu K, Hang D (2013) Restoration of horizontal stability in complete acromioclavicular joint separations: surgical technique and preliminary results. Eur J Med Res 18:42

    CAS  PubMed  PubMed Central  Google Scholar 

  26. Liu HH, Chou YJ, Chen CH, Chia WT, Wong CY (2010) Surgical treatment of acute acromioclavicular joint injuries using a modified Weaver-Dunn procedure and clavicular hook plate. Orthopedics. https://doi.org/10.3928/01477447-20100625-10

    Article  PubMed  Google Scholar 

  27. Maier D, Jaeger M, Reising K, Feucht MJ, Sudkamp NP, Izadpanah K (2016) Injury patterns of the acromioclavicular ligament complex in acute acromioclavicular joint dislocations: a cross-sectional, fundamental study. Bmc Musculoskelet Disord 17:385

    PubMed  PubMed Central  Google Scholar 

  28. Michlitsch MG, Adamson GJ, Pink M, Estess A, Shankwiler JA, Lee TQ (2010) Biomechanical comparison of a modified Weaver-Dunn and a free-tissue graft reconstruction of the acromioclavicular joint complex. Am J Sports Med 38:1196–1203

    PubMed  Google Scholar 

  29. Minkus M, Hann C, Scheibel M, Kraus N (2017) Quantification of dynamic posterior translation in modified bilateral Alexander views and correlation with clinical and radiological parameters in patients with acute acromioclavicular joint instability. Arch Orthop Trauma Surg 137:845–852

    PubMed  Google Scholar 

  30. Pastor MF, Averbeck AK, Welke B, Smith T, Claassen L, Wellmann M (2016) The biomechanical influence of the deltotrapezoid fascia on horizontal and vertical acromioclavicular joint stability. Arch Orthop Trauma Surg 136:513–519

    CAS  PubMed  Google Scholar 

  31. Rockwood CAJ, Williams GR, Young CD (1996) Injuries to the acromioclavicular joint. Fractures in adults. Lippincott, Philadelphia, S 1341–1431

    Google Scholar 

  32. Saier T, Venjakob AJ, Minzlaff P, Fohr P, Lindell F, Imhoff AB et al (2015) Value of additional acromioclavicular cerclage for horizontal stability in complete acromioclavicular separation: a biomechanical study. Knee Surg Sports Traumatol Arthrosc 23:1498–1505

    PubMed  Google Scholar 

  33. Salter EG Jr., Nasca RJ, Shelley BS (1987) Anatomical observations on the acromioclavicular joint and supporting ligaments. Am J Sports Med 15:199–206

    PubMed  Google Scholar 

  34. Sandmann GH, Martetschlager F, Mey L, Kraus TM, Buchholz A, Ahrens P et al (2012) Reconstruction of displaced acromio-clavicular joint dislocations using a triple suture-cerclage: description of a safe and efficient surgical technique. Patient Saf Surg 6:25

    PubMed  PubMed Central  Google Scholar 

  35. Scheibel M, Droschel S, Gerhardt C, Kraus N (2011) Arthroscopically assisted stabilization of acute high-grade acromioclavicular joint separations. Am J Sports Med 39:1507–1516

    PubMed  Google Scholar 

  36. Scheibel M, Habermeyer P (2005) Current procedures for clinical evaluation of the shoulder. Orthopade 34:267–283

    CAS  PubMed  Google Scholar 

  37. Schönaich M, Voigt C, Lill H (2013) Frakturen und Luxationen des Schultergürtels. In: Ruchholtz S, Wirtz DC (Hrsg) Essentials Orthopädie und Unfallchirurgie, 2. Aufl. Thieme, Stuttgart, S 343–358

    Google Scholar 

  38. Shin SJ, Yun YH, Yoo JD (2009) Coracoclavicular ligament reconstruction for acromioclavicular dislocation using 2 suture anchors and coracoacromial ligament transfer. Am J Sports Med 37:346–351

    PubMed  Google Scholar 

  39. Tauber M, Koller H, Hitzl W, Resch H (2010) Dynamic radiologic evaluation of horizontal instability in acute acromioclavicular joint dislocations. Am J Sports Med 38:1188–1195

    PubMed  Google Scholar 

  40. Teece RM, Lunden JB, Lloyd AS, Kaiser AP, Cieminski CJ, Ludewig PM (2008) Three-dimensional acromioclavicular joint motions during elevation of the arm. J Orthop Sports Phys Ther 38:181–190

    PubMed  Google Scholar 

  41. Tischer T, Salzmann GM, El-Azab H, Vogt S, Imhoff AB (2009) Incidence of associated injuries with acute acromioclavicular joint dislocations types III through V. Am J Sports Med 37:136–139

    PubMed  Google Scholar 

  42. van Bergen CJA, van Bemmel AF, Alta TDW, van Noort A (2017) New insights in the treatment of acromioclavicular separation. World J Orthop 8:861–873

    PubMed  PubMed Central  Google Scholar 

  43. Weinstein DM, McCann PD, McIlveen SJ, Flatow EL, Bigliani LU (1995) Surgical treatment of complete acromioclavicular dislocations. Am J Sports Med 23:324–331

    CAS  PubMed  Google Scholar 

  44. Wellmann M, da Silva G, Lichtenberg S, Magosch P, Habermeyer P (2013) Instability pattern of acromioclavicular joint dislocations type Rockwood III: relevance of horizontal instability. Orthopade 42:271–277

    CAS  PubMed  Google Scholar 

  45. Zumstein MA, Schiessl P, Ambuehl B, Bolliger L, Weihs J, Maurer MH et al (2017) New quantitative radiographic parameters for vertical and horizontal instability in acromioclavicular joint dislocations. Knee Surg Sports Traumatol Arthrosc. https://doi.org/10.1007/s00167-017-4579-6

    Article  PubMed  PubMed Central  Google Scholar 

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Author information

Authors and Affiliations

  1. Klinik für Orthopädie und Unfallchirurgie, St. Josef Hospital, Ruhr-Universität Bochum, Gudrunstraße 56, 44791, Bochum, Deutschland

    B. Bockmann

  2. II. Orthopädische Abteilung, Herz-Jesu-Krankenhaus Wien, Baumgasse 20a, Wien, 1030, Österreich

    R. C. Ostermann

  3. Klinik für Arthroskopie und Sportorthopädie, Marienkrankenhaus Kaiserswerth, Düsseldorf, Deutschland

    A. J. Venjakob & W. Nebelung

  4. Centrum für Muskuloskeletale Chirurgie, Charité – Universitätsmedizin, Berlin, Deutschland

    N. Maziak & P. Moroder

  5. Klinik für Orthopädie und Unfallchirurgie, Alfried Krupp Krankenhaus Rüttenscheid, Essen, Deutschland

    J. Streich

  6. Klinik für Orthopädie und Unfallchirurgie, Klinikum der Albert-Ludwigs-Universität Freiburg, Freiburg, Deutschland

    A. Hupperich & D. Maier

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  1. B. Bockmann
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  8. A. Hupperich
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Correspondence to B. Bockmann.

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Interessenkonflikt

P. Moroder gibt an, dass er grants, consultation fees und Honorare der Firma Arthrex erhält. B. Bockmann, R.C. Ostermann, A. Venjakob, W. Nebelung, N. Maziak, J. Streich, A. Hupperich und D. Maier 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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Bockmann, B., Ostermann, R.C., Venjakob, A.J. et al. Bedeutung und Behandlung der horizontalen Instabilitätskomponente bei Verletzungen des Akromioklavikulargelenks. Obere Extremität 15, 42–51 (2020). https://doi.org/10.1007/s11678-019-0525-1

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