Reconstruction of the Coracoclavicular Ligament Complex Utilizing an All-Suture Tape Cerclage Technique
Current techniques for the operative management of acromioclavicular joint separation injuries are plagued by a high rate of postoperative complications. Loss of fixation has been the most difficult challenge to overcome, with a recent meta-analysis finding postoperative subluxation in over 20% of c...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-01-01
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| Series: | Arthroscopy Techniques |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2212628724003177 |
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| author | William A. Ranson, M.D. Laura Thurber, M.D. Akshar V. Patel, B.S. Christoph Schroen, B.S. Carl M. Cirino, M.D. Patrick J. Denard, M.D. Paul J. Cagle, M.D. |
| author_facet | William A. Ranson, M.D. Laura Thurber, M.D. Akshar V. Patel, B.S. Christoph Schroen, B.S. Carl M. Cirino, M.D. Patrick J. Denard, M.D. Paul J. Cagle, M.D. |
| author_sort | William A. Ranson, M.D. |
| collection | DOAJ |
| description | Current techniques for the operative management of acromioclavicular joint separation injuries are plagued by a high rate of postoperative complications. Loss of fixation has been the most difficult challenge to overcome, with a recent meta-analysis finding postoperative subluxation in over 20% of cases. No gold-standard surgical treatment has been established despite over 100 unique procedures having been described in the literature. All-suture fixation techniques have shown promise but were previously limited by issues inherent to the properties of the available suture materials. Recently, however, a modern suture product with unique properties has been made commercially available. The senior authors sought to adapt this material to fixation of injuries of the coracoclavicular ligament complex. In this Technical Note, we present an all-suture tape cerclage technique for the fixation of high-grade acromioclavicular separation injuries (Rockwood types IV, V, and VI). By controlling the ultimate knot stack position through the directionality of suture passage, this technique negates the risk of subsequent hardware irritation. Further, by avoiding the formation of coracoid tunnels, the risk of iatrogenic coracoid fracture is minimized. Importantly, this technique is simple and reproducible while also minimizing material requirements and cost. |
| format | Article |
| id | doaj-art-7f2adf083df249adbdf12913a2e7af9d |
| institution | Kabale University |
| issn | 2212-6287 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroscopy Techniques |
| spelling | doaj-art-7f2adf083df249adbdf12913a2e7af9d2025-01-30T05:14:10ZengElsevierArthroscopy Techniques2212-62872025-01-01141103184Reconstruction of the Coracoclavicular Ligament Complex Utilizing an All-Suture Tape Cerclage TechniqueWilliam A. Ranson, M.D.0Laura Thurber, M.D.1Akshar V. Patel, B.S.2Christoph Schroen, B.S.3Carl M. Cirino, M.D.4Patrick J. Denard, M.D.5Paul J. Cagle, M.D.6Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A.Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A.Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A.Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A.Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, U.S.A.Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, Portland, Oregon, U.S.A.Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A.; Address correspondence to Paul J. Cagle, M.D., 425 West 59th Street, New York, New York, 10019, U.S.A.Current techniques for the operative management of acromioclavicular joint separation injuries are plagued by a high rate of postoperative complications. Loss of fixation has been the most difficult challenge to overcome, with a recent meta-analysis finding postoperative subluxation in over 20% of cases. No gold-standard surgical treatment has been established despite over 100 unique procedures having been described in the literature. All-suture fixation techniques have shown promise but were previously limited by issues inherent to the properties of the available suture materials. Recently, however, a modern suture product with unique properties has been made commercially available. The senior authors sought to adapt this material to fixation of injuries of the coracoclavicular ligament complex. In this Technical Note, we present an all-suture tape cerclage technique for the fixation of high-grade acromioclavicular separation injuries (Rockwood types IV, V, and VI). By controlling the ultimate knot stack position through the directionality of suture passage, this technique negates the risk of subsequent hardware irritation. Further, by avoiding the formation of coracoid tunnels, the risk of iatrogenic coracoid fracture is minimized. Importantly, this technique is simple and reproducible while also minimizing material requirements and cost.http://www.sciencedirect.com/science/article/pii/S2212628724003177 |
| spellingShingle | William A. Ranson, M.D. Laura Thurber, M.D. Akshar V. Patel, B.S. Christoph Schroen, B.S. Carl M. Cirino, M.D. Patrick J. Denard, M.D. Paul J. Cagle, M.D. Reconstruction of the Coracoclavicular Ligament Complex Utilizing an All-Suture Tape Cerclage Technique Arthroscopy Techniques |
| title | Reconstruction of the Coracoclavicular Ligament Complex Utilizing an All-Suture Tape Cerclage Technique |
| title_full | Reconstruction of the Coracoclavicular Ligament Complex Utilizing an All-Suture Tape Cerclage Technique |
| title_fullStr | Reconstruction of the Coracoclavicular Ligament Complex Utilizing an All-Suture Tape Cerclage Technique |
| title_full_unstemmed | Reconstruction of the Coracoclavicular Ligament Complex Utilizing an All-Suture Tape Cerclage Technique |
| title_short | Reconstruction of the Coracoclavicular Ligament Complex Utilizing an All-Suture Tape Cerclage Technique |
| title_sort | reconstruction of the coracoclavicular ligament complex utilizing an all suture tape cerclage technique |
| url | http://www.sciencedirect.com/science/article/pii/S2212628724003177 |
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