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distal clavicle excision

Mark J Amirtharaj, Dean Wang, Michael H McGraw, Christopher L Camp, Ryan A Degen, David M Dines, Joshua S Dines
PURPOSE: (1) Define the epidemiologic trend of distal clavicle excision (DCE) for acromioclavicular (AC) joint arthritis among board-eligible orthopaedic surgeons in the United States, (2) describe the rates and types of reported complications of open and arthroscopic DCE, and (3) evaluate the effect of fellowship training on preferred technique and reported complication rates. METHODS: The American Board of Orthopaedic Surgery (ABOS) database was used to identify DCE cases submitted by ABOS Part II Board Certification examination candidates...
February 21, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Michael B Banffy, Carlos Uquillas, Julie A Neumann, Neal S ElAttrache
BACKGROUND: An anatomic double-tunnel (DT) reconstruction technique has been widely adopted to reconstruct the ruptured coracoclavicular (CC) ligaments seen with high-grade acromioclavicular (AC) joint injuries. However, the anatomic DT reconstruction has been associated with the risk of clavicle fractures, which may be problematic, particularly for contact athletes. Purpose/Hypothesis: The purpose was to compare a single-tunnel (ST) CC ligament reconstruction for AC joint injuries with the native state as well as with the more established anatomic DT CC ligament reconstruction...
February 1, 2018: American Journal of Sports Medicine
Adam Kwapisz, Kelly Fitzpatrick, Jay B Cook, George S Athwal, John M Tokish
BACKGROUND: Bone loss in shoulder instability is a well-recognized cause of failure after stabilization surgery. Many approaches have been described to address glenoid bone loss, including coracoid transfer. This transfer can be technically difficult and has been associated with high complication rates. An ideal alternative to coracoid transfer would be an autologous source of fresh osteochondral graft with enough surface area to replace significant glenoid bone loss. The distal clavicle potentially provides such a graft source that is readily available and low-cost...
January 1, 2018: American Journal of Sports Medicine
John Begly, Vineet Tyagi, Eric Strauss
Diffuse idiopathic skeletal hyperostosis (DISH) is common spinal condition characterized by increased calcification and ossification of ligaments and entheses, typically in the anterior aspect of the spine. However, extraspinal manifestations of the disease can occur and depending on the degree and location of involvement, may become symptomatic. We present the case of a 63-year-old male with a history of DISH, who failed initial open distal clavicle excision due to the postoperative development of heterotopic bone bridging across the acromioclavicular joint...
December 2017: Bulletin of the Hospital for Joint Diseases
Adinun Apivatgaroon, Prakasit Sanguanjit
Acromioclavicular joint osteoarthritis can lead to persistent shoulder pain. Distal clavicle excision is the most common operative procedure in patients with failed, conservative symptomatic acromioclavicular joint osteoarthritis treatment, with some reports of complications. This report describes an alternative procedure that can be used to excise the distal clavicle together with the medial border of the acromion. This technique is a simple procedure because the standard distal clavicle excision can preserve the acromioclavicular ligament, as well as the joint capsule, and achieve an adequate resection length...
February 2017: Arthroscopy Techniques
Samuel A Taylor, Ryan M Degen, Alexander E White, Moira M McCarthy, Lawrence V Gulotta, Stephen J O'Brien, Brian C Werner
BACKGROUND: Data regarding risk factors for revision surgery after superior labral anterior-posterior (SLAP) repair are limited to institutional series. PURPOSE: To define risk factors for revision surgery after SLAP repair among patients in a large national database. STUDY DESIGN: Case-control study; Level of evidence, 3. METHODS: A national insurance database was queried for patients undergoing arthroscopic SLAP repair (Current Procedural Terminology [CPT] code 29807) for the diagnosis of a SLAP tear...
June 2017: American Journal of Sports Medicine
Sho Okimatsu, Hiroto Kamoda, Tsukasa Yonemoto, Shintaro Iwata, Takeshi Ishii
Clavicula pro humero (CPH) reconstruction is a method that is used after proximal humeral excision. During CPH reconstruction, the ipsilateral clavicle is rotated downward and connected to the preserved distal humerus by using plates and screws. This method is frequently used for reconstruction surgeries involving young patients and has positive outcomes. In this study, we describe two cases of CPH reconstruction that were performed on elderly individuals after wide resection of the proximal humerus; postoperative results from these surgeries were satisfactory...
2016: Case Reports in Oncological Medicine
Jordan C Villa, Jelle P van der List, Elizabeth B Gausden, Dean G Lorich, David L Helfet, Peter Kloen, David S Wellman
INTRODUCTION: The optimal treatment for distal clavicle nonunions remains unknown. Small series have reported outcomes following distal fragment excision and various fixation techniques. We present the clinical, radiographic and functional outcomes after superior plating or double (superior and anteroinferior) plating in combination with bone grafting as treatment for distal clavicle nonunions. METHODS: We collected demographic and radiographic data from a consecutive series of ten patients with symptomatic nonunion of the distal clavicle treated since 1998...
November 2016: Archives of Orthopaedic and Trauma Surgery
Tae-Soo Park, Kwang-Won Lee
BACKGROUND: Symptomatic acromioclavicular joint (ACJ) lesions are a common cause of shoulder complaints that can be treated successfully with both conservative and surgical methods. There are several operative techniques, including both open and arthroscopic surgery, for excising the distal end of the clavicle. Here, we present a new modified arthroscopic technique for painful osteoarthritis of the ACJ and evaluate its clinical outcomes. Our hypothesis was that 4- to 7-mm resection of the distal clavicle in an en bloc fashion would have several advantages, including no bony remnants, maintenance of stability of the ACJ, and reduced prevalence of heterotopic ossification, in addition to elimination of the pathologic portion of the distal clavicle...
July 2016: Indian Journal of Orthopaedics
Dean Wang, Benjamin E Bluth, Chad R Ishmael, Jeremiah R Cohen, Jeffrey C Wang, Frank A Petrigliano
PURPOSE: Prior studies have reported high complication rates with acromioclavicular joint reconstruction (ACJR). However, many of these reports have suffered from small sample sizes and inclusion of older surgical techniques. The purpose of this study was to determine the rates of early complications requiring reoperation in patients treated with ACJR. METHODS: From 2007 to 2011, patients who were treated with ACJR were identified using the PearlDiver database, a large insurance database in the USA...
July 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Arnaldo Amado Ferreira Neto, Cassio Silva Trevizani, Eduardo Benegas, Eduardo Angeli Malavolta, Mauro Emílio Conforto Gracitelli, Alexandre Carneiro Bitar, Francisco José Dos Santos Neto
UNLABELLED: To evaluate the clinical and radiographic results from arthroscopic surgical treatment of the rotator cuff in patients with calcifying tendinitis. METHOD: A retrospective study was conducted on twenty patients who underwent arthroscopic treatment for calcifying tendinitis of the shoulder between March 1999 and November 2005. Six patients were excluded due to loss of follow-up. The average follow-up period was 41.4 months. Eight patients (57%) were female and six (43%) were male...
September 2010: Revista Brasileira de Ortopedia
K Gokkus, M Saylik, H Atmaca, E Sagtas, A T Aydin
INTRODUCTION: Resection of the distal aspect of clavicle has a well-documented treatment modality in case of acromioclavicular joint osteoarthritis resistant to conservative treatment. HYPOTHESIS: Limited (mean ∼0.5cm distal end of clavicle resection) distal clavicle excision of A-C joint arthritis in cases resistant to conservative treatment may reduce the pain and improve the shoulder function. MATERIAL AND METHODS: In this study, we retrospectively evaluated the results of limited distal clavicle excision of acromioclavicular joint osteoarthritis resistant to conservative treatment...
May 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Nathaniel Hiscock, Simon Bell, Jennifer Coghlan
BACKGROUND: The surgical repair of shoulder pathologies, including rotator cuff disease and acromio-clavicular joint arthritis, have undergone many technical advances. However the debilitating postoperative stiff shoulder remains a common and significant complication of these surgeries, occurring in 4.9 to 23.2 % of patients undergoing rotator cuff repairs. The pathology of the pathological postoperative stiff shoulder and its associated condition "frozen shoulder" are poorly understood and both lack formal objective clinical diagnostic criteria...
December 4, 2015: BMC Musculoskeletal Disorders
Karl A Illig, Wesley Gabbard, Aurelia Calero, Charles Bailey, Murray Shames, Paul Armstrong, Peter R Nelson
BACKGROUND: A substantial number of patients with threatened arteriovenous (AV) access are found to have stenoses at the costoclavicular junction (CCJ), which frequently are resistant to angioplasty and stenting. We believe that stenoses in this location will not resolve unless bony decompression is performed to relieve the extrinsic compression on the vein. This article describes our short- to medium-term results following such decompression in patients with failing fistulae. METHODS: We reviewed a prospectively maintained database to identify all patients with threatened AV access operated on for stenoses at the CCJ...
2015: Annals of Vascular Surgery
Bradley S Tragord, Liem T Bui-Mansfield, Theodore Croy, Scott W Shaffer
STUDY DESIGN: Resident's case problem. BACKGROUND: Acromioclavicular joint pathology is reported to be present in up to 30% of all patients complaining of shoulder dysfunction. The operative approach to treating acromioclavicular joint disease often includes a distal clavicle excision and, in circumstances of acromioclavicular joint instability, reconstruction of the coracoclavicular and/or the acromioclavicular ligament. Surgical complications for these procedures are rare, but potentially include suprascapular neuropathy secondary to the course of the suprascapular nerve posterior to the clavicle prior to entering the supraspinatus fossa...
April 2015: Journal of Orthopaedic and Sports Physical Therapy
Hz Chan, Cl Ooi, My Lim, Eks Ong, O Zulkiflee
ABSTRACT: Shoulder impingement syndrome and acromioclavicular joint osteoarthritis often occur simultaneously and easily missed. Kay et al. reported excellent results with combined arthroscopic subacromial decompression and resection of the distal end of the clavicle in patients with both disorders(1). Arthroscopic treatment of these disorders produces more favourable results than open procedures. We report two patients who were not responding to conservative management and were treated with direct arthroscopic distal clavicle excision and subacromial decompression in single setting...
July 2014: Malaysian Orthopaedic Journal
Brian G Webb, Michael P Elliott
Arthroscopic shoulder surgery is considered a safe and effective method of treating a variety of shoulder pathologies and is associated with a low complication rate. The type and rate of complications can vary, depending on the procedure, positioning, surgical time, and anesthesia. Fortunately, neurovascular injuries occur infrequently. Numerous studies have described the proximity of neurovascular structures to portals placed in shoulder arthroscopy, in both the beach chair and the lateral decubitus positions...
June 2014: Orthopedics
Ram K Alluri, Asher I Kupperman, Scott R Montgomery, Jeffrey C Wang, Sharon L Hame
PURPOSE: The purpose of this study was to evaluate and quantify the demographic characteristics of patients undergoing open and arthroscopic distal clavicle excision (DCE) in the United States while also describing changes in practice patterns over time. METHODS: Patients who underwent DCE from 2004 to 2009 were identified by Current Procedural Terminology (CPT) codes in a national database of orthopaedic insurance records. The year of procedure, age, sex, geographic region, and concomitant rotator cuff repair or subacromial decompression (SAD) were recorded for each patient...
September 2014: Arthroscopy: the Journal of Arthroscopic & related Surgery
Filon Agathangelidis, Achilleas Boutsiadis, Evangelia Fouka, Dimitrios Karataglis
A 48-year-old man was being treated unsuccessfully for miliary tuberculosis for 5 months until he presented with acromioclavicular joint swelling. Imaging of the shoulder revealed destruction of the acromioclavicular joint and the patient was brought to the operating theatre and underwent the excision of the distal end of the clavicle, synovectomy and drainage of the abscess. Surgery was followed by prompt clinical, functional and radiological improvement. Histopathology confirmed the diagnosis of acromioclavicular tuberculosis...
June 21, 2013: BMJ Case Reports
Andrew B Beaver, Brent G Parks, Richard Y Hinton
BACKGROUND: Acromioclavicular (AC) joint separation is a common injury, usually affecting young adults. Controversy exists regarding whether to excise the distal clavicle when surgical intervention is required. PURPOSE: To evaluate the biomechanical strength of AC and coracoclavicular (CC) ligament reconstruction with and without concurrent distal clavicle excision. STUDY DESIGN: Controlled laboratory study. METHODS: Nine matched pairs of cadaver shoulders were used...
July 2013: American Journal of Sports Medicine
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