Failed Loop Endobutton Acromioclavicular Joint Reconstruction Treated with Duo Figure of 8 FiberTape Augmented Autogenic Graft Wrapping Technique: A Case Report
Introduction: Acromioclavicular joint (ACJ) injuries are prevalent among young, active individuals and account for a significant proportion of shoulder girdle and collision sports injuries. The Rockwood classification system categorizes these injuries from Type I to VI, guiding treatment from conser...
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| Format: | Article |
| Language: | English |
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Indian Orthopaedic Research Group
2025-04-01
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| Series: | Journal of Orthopaedic Case Reports |
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| Online Access: | https://jocr.co.in/wp/2025/04/01/failed-loop-endobutton-acromioclavicular-joint-reconstruction-treated-with-duo-figure-of-8-fibertape-augmented-autogenic-graft-wrapping-technique-a-case-report/ |
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| author | Saurabh Singh Sushit Kumar Sonu Rahul Patel Kumar Prashant Himanshu Nagar |
| author_facet | Saurabh Singh Sushit Kumar Sonu Rahul Patel Kumar Prashant Himanshu Nagar |
| author_sort | Saurabh Singh |
| collection | DOAJ |
| description | Introduction:
Acromioclavicular joint (ACJ) injuries are prevalent among young, active individuals and account for a significant proportion of shoulder girdle and collision sports injuries. The Rockwood classification system categorizes these injuries from Type I to VI, guiding treatment from conservative management to surgical intervention. Despite various surgical techniques, including the Fiber-loop Endobutton method, failure rates, and complications remain a concern, particularly in cases of post-operative instability.
Case Report:
A 50-year-old male presented with persistent right shoulder pain and deformity following an initial Type-V ACJ injury from a road traffic accident. The patient had undergone surgical stabilization with a Fiber-loop Endobutton construct. However, 17th days post-surgery, he experienced a recurrence of pain and deformity, with radiographs revealing the failure of the initial repair. Subsequent imaging indicated a mal-positioned Endobutton and potential coracoid blowout, likely due to inadequate drill hole placement. Three weeks later, the patient underwent revision surgery using a double figure-of-8 autogenic loop reconstruction with FiberTape and hamstring tendon graft. The procedure involved removing the failed hardware, drilling new holes in the clavicle, and securing the ACJ with FiberTape and a hamstring graft. The graft was looped around the coracoid and clavicle in a figure-of-8 manner to replicate acromioclavicular ligament anatomy and ensure both horizontal and vertical stability. At 6 weeks, follow-up radiographs demonstrated near-anatomic alignment of the ACJ and coracoclavicular. The patient reported minimal pain and regained a near-full range of motion. By 6 months, while slight radiographic changes were noted, the patient remained asymptomatic with excellent functional outcomes and minimal limitations.
Conclusion:
This case highlights the challenges of managing post-operative instability in ACJ injuries. The successful use of a dual figure-of-8 graft technique provides a viable solution for revision surgery, offering satisfactory stability and functional recovery. Further research is needed to optimize salvage techniques for complex cases. |
| format | Article |
| id | doaj-art-8638b80a661b4cc89b9115b6e98852df |
| institution | OA Journals |
| issn | 2250-0685 2321-3817 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Indian Orthopaedic Research Group |
| record_format | Article |
| series | Journal of Orthopaedic Case Reports |
| spelling | doaj-art-8638b80a661b4cc89b9115b6e98852df2025-08-20T02:37:09ZengIndian Orthopaedic Research GroupJournal of Orthopaedic Case Reports2250-06852321-38172025-04-0115418619110.13107/jocr.2025.v15.i04.5494Failed Loop Endobutton Acromioclavicular Joint Reconstruction Treated with Duo Figure of 8 FiberTape Augmented Autogenic Graft Wrapping Technique: A Case ReportSaurabh SinghSushit Kumar SonuRahul PatelKumar PrashantHimanshu NagarIntroduction: Acromioclavicular joint (ACJ) injuries are prevalent among young, active individuals and account for a significant proportion of shoulder girdle and collision sports injuries. The Rockwood classification system categorizes these injuries from Type I to VI, guiding treatment from conservative management to surgical intervention. Despite various surgical techniques, including the Fiber-loop Endobutton method, failure rates, and complications remain a concern, particularly in cases of post-operative instability. Case Report: A 50-year-old male presented with persistent right shoulder pain and deformity following an initial Type-V ACJ injury from a road traffic accident. The patient had undergone surgical stabilization with a Fiber-loop Endobutton construct. However, 17th days post-surgery, he experienced a recurrence of pain and deformity, with radiographs revealing the failure of the initial repair. Subsequent imaging indicated a mal-positioned Endobutton and potential coracoid blowout, likely due to inadequate drill hole placement. Three weeks later, the patient underwent revision surgery using a double figure-of-8 autogenic loop reconstruction with FiberTape and hamstring tendon graft. The procedure involved removing the failed hardware, drilling new holes in the clavicle, and securing the ACJ with FiberTape and a hamstring graft. The graft was looped around the coracoid and clavicle in a figure-of-8 manner to replicate acromioclavicular ligament anatomy and ensure both horizontal and vertical stability. At 6 weeks, follow-up radiographs demonstrated near-anatomic alignment of the ACJ and coracoclavicular. The patient reported minimal pain and regained a near-full range of motion. By 6 months, while slight radiographic changes were noted, the patient remained asymptomatic with excellent functional outcomes and minimal limitations. Conclusion: This case highlights the challenges of managing post-operative instability in ACJ injuries. The successful use of a dual figure-of-8 graft technique provides a viable solution for revision surgery, offering satisfactory stability and functional recovery. Further research is needed to optimize salvage techniques for complex cases.https://jocr.co.in/wp/2025/04/01/failed-loop-endobutton-acromioclavicular-joint-reconstruction-treated-with-duo-figure-of-8-fibertape-augmented-autogenic-graft-wrapping-technique-a-case-report/revision acromioclavicular joint surgerysuspension fixation failureloop endobuttonacromioclavicular joint |
| spellingShingle | Saurabh Singh Sushit Kumar Sonu Rahul Patel Kumar Prashant Himanshu Nagar Failed Loop Endobutton Acromioclavicular Joint Reconstruction Treated with Duo Figure of 8 FiberTape Augmented Autogenic Graft Wrapping Technique: A Case Report Journal of Orthopaedic Case Reports revision acromioclavicular joint surgery suspension fixation failure loop endobutton acromioclavicular joint |
| title | Failed Loop Endobutton Acromioclavicular Joint Reconstruction Treated with Duo Figure of 8 FiberTape Augmented Autogenic Graft Wrapping Technique: A Case Report |
| title_full | Failed Loop Endobutton Acromioclavicular Joint Reconstruction Treated with Duo Figure of 8 FiberTape Augmented Autogenic Graft Wrapping Technique: A Case Report |
| title_fullStr | Failed Loop Endobutton Acromioclavicular Joint Reconstruction Treated with Duo Figure of 8 FiberTape Augmented Autogenic Graft Wrapping Technique: A Case Report |
| title_full_unstemmed | Failed Loop Endobutton Acromioclavicular Joint Reconstruction Treated with Duo Figure of 8 FiberTape Augmented Autogenic Graft Wrapping Technique: A Case Report |
| title_short | Failed Loop Endobutton Acromioclavicular Joint Reconstruction Treated with Duo Figure of 8 FiberTape Augmented Autogenic Graft Wrapping Technique: A Case Report |
| title_sort | failed loop endobutton acromioclavicular joint reconstruction treated with duo figure of 8 fibertape augmented autogenic graft wrapping technique a case report |
| topic | revision acromioclavicular joint surgery suspension fixation failure loop endobutton acromioclavicular joint |
| url | https://jocr.co.in/wp/2025/04/01/failed-loop-endobutton-acromioclavicular-joint-reconstruction-treated-with-duo-figure-of-8-fibertape-augmented-autogenic-graft-wrapping-technique-a-case-report/ |
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