Arthroscopic fixation of acute acromioclavicular joint. Arthrex pcl tightrope, additional information, april. The ac joint tightrope variable drill guide with coracoid drill stop attachment arthrex is inserted through the anteroinferior portal. Arthroscopic fixation for acute acromioclavicular joint. The arthrex pcl tightrope is intended to be used for fixation of bone to bone or soft tissue to bone, and is intended as fixation posts, a distribution bridge, or for distributing suture tension over areas of ligament or tendon repair. The acl tightrope eliminates the need for multiple implant sizes and facilitates complete graft fill of short femoral sockets, which are common with anatomic acl drilling.
Arthroscopic acromioclavicular joint reconstruction with tightrope. Open stabilization of acute acromioclavicular joint. Tightrope reconstruction of the ac joint is a reproducible and safe. The ac tightrope family of products provides for easy reconstruction of acute ac joint separations in a minimally invasive manner, either open or arthroscopic. Arthroscopic acromioclavicular joint reconstruction using knotless. The anatomic reconstruction of the ac joint using tightrope is a stable and functional anatomic reconstruction procedure. The twin tail tightrope is another evolution of the tightrope that features two independent clavicle button tails and is designed to help reduce and stabilize the ac joint for open, acute ac injuries. Nguyen, in shoulder and elbow trauma and its complications, 2015. Tightrope fixation of complex acromioclavicular separation. The tightrope ligament is produced by arthrex vet systems.
Twelve ac reconstruction procedures used a single tightrope with an allograft tissue loop around the coracoid and. Animation of the arthrex tightrope technique for acute ac joint dislocation. We retrospectively analyzed our data for the first year using prp, including all patients who received cruciate ligament repair surgery using an implant usually a tightrope, or a fiberwire. Department of orthopaedics, the ohio state university, columbus, oh address correspondence and reprint requests to gregory berlet, md, department of orthopaedics, the ohio state university, 456 west 10th avenue, 4110 cramblett hall. The arthrex tightrope is a device consisting of two buttons one round.
Next, the ac joint tightrope guide arthrex is inserted through the anterior portal and is positioned such that the tip is just under the base of the center of the coracoid. The tightrope arthrex, naples, fl is one of the adjustableelooplength suspensory. Brace will be worn for 10 weeks to protect graft, 0 to 90 degrees. Functional results were assessed using the constant score, and disabilities of arm, shoulder and hand dash and rand 36ltem health survey scores after a mean 2. Ac joint injuries are most commonly caused by a direct lateral impact at the acromion with the arm in an adducted position. Through the anteriorinferior portal, the ac tightrope constant guide arthrex was inserted, and its tip was positioned under the coracoid base fig. Platelet rich plasmaacp system arthrex we have been using platelet rich plasma prpacp system, arthrex as part of our surgical protocol since fall 2012. The guide pin sleeve arthrex was placed over the clavicle at its midline approximately 35 mm from the distal clavicle through a 1.
He sustained a right ac and coracoclavicular cc joint separation with posterior displacement of the proximal clavicle fracture fragment. Arthrex in an antegrade direction through the transosseous clavicle and coracoid tunnels. The acl tightrope offers adjustable cortical fixation for cruciate ligament reconstruction. Eight ac reconstruction procedures used the graft rope arthrex, naples, fl device with allograft tissue gr.
The twin tail tightrope features two independent clavicle button tails and is designed to help reduce and stabilize the ac joint for open, acute ac injuries. Primary acromioclavicularcoracoclavicular reconstruction. A suture tensioner is mandatory for proper tensioning of the tightrope device. Arthrex s proprietary 4point knotless fixation resists cyclic displacement. As part of this professional usage, the medical professional must use. A passing suture is then passed through the coracoid and snapped for later passage of the ac tightrope. Results of arthroscopyassisted tightrope repair of.
Vayser, dpm shantanu patil, md gokhan meric, md introduction hallux abducto valgus hav or bunion deformity, as it is commonly known, affects many people around the world. The arm of the guide can be used to appropriately position the. Surgical technique affects outcomes in acromioclavicular. Locked in full extension for walking and sleeping for first week may allow 90 degrees flexion after first week given. Ac tightrope repair kit, twin tail tightrope, dog bone button with fibertape. Constant guide for ac tightrope ar2255cg long drill, 4 mm cannulated ar1204lx instrumentation not included in ar2255cgs retroconstruction drill guide ar1510h retroconstruction constant femoral guide graduated drill sleeve, i. Radiographic displacement of acute acromioclavicular joint.
Using the same 3mm cannulated drill bit, a tunnel is drilled from superior to inferior, and the drill bit is left in place. Surgical outcome following arthroscopic fixation of. The primary objective of this technical note is to describe the treatment of acute highgrade ac joint dislocations with an arthroscopic ac joint reconstruction with tightrope and fibertape arthrex, naples, fl. Ac joint separation can be effectively treated using the ac tightrope technique. In total, 80100 n is applied for each suture, which can lead to a slight overreduction of the ac joint, which is acceptable fig. It is designed specifically for ligament repair and provides a method for consistent isometric implant placement. Arthroscopic stabilization of acute acromioclavicular. Ac repair procedures used one ac tightrope device 1tr. The arthrex tightrope is a device consisting of two buttons one round clavicle button and one oblong coracoid button. Both ends of this device consist of an oblong coracoid button and a round clavicular button, and the 2 metal. The objective of this study was to evaluate the preliminary radiographic and clinical results of grade iv and v acromioclavicular joint disruption repair using the arthroscopic arthrex. The tightrope device is pulled tightly against the femur.
Constant guide for ac tightrope ar2255cg long drill, 4 mm cannulated ar1204lx ac joint coracoid graft passing instrument, left ar2256l ac joint coracoid graft passing instrument, right ar2256r. Arthrex cmc mini tightrope, mar 10 2014 ad special 510k. It is 2 metal buttons, 1 circular and 1 oblong, joined by a continuous loop of fiberwire suture arthrex. Arthroscopic stabilization of acute acromioclavicular ac joint tightrope fixation joint dislocation using the tightrope. It is an ultrahigh strength, flat, smooth, braided, ribbonlike ligament composed of a multistranded long chain ultrahigh molecular weight polyethylene uhmwpe core with a braided jacket of polyester giving it unsurpassed strength, virtually eliminating ligament breakage. Weightlifters shoulder pain from an unstable ac joint feat. The advantages and disadvantages of the technique are outlined in table 1. The tightrope system arthrex, naples, florida is a device designed originally for the reduction and stabilization of the tibio.
Functional results were assessed using the constant score, and disabilities of arm, shoulder and hand dash and rand 36. The fracture of the distal third of the clavicle was treated by suture fixation fig. Therefore, different material implants are provided. The dog bone button, utilized as part of the ac dog bone technique for ac joint separation, utilizes fibertape, passed independently through the coracoid and clavicular bone tunnels, to provide mechanical fixation through small tunnels. Inserting the tightrope the surgeon inserts the ends of the tightrope device through the femoral tunnel. Highgrade acromioclavicular ac injuries are frequent in the active population, and their. Arthroscopic fixation of acute acromioclavicular joint disruption with.
The tightrope ccl technique seeks to optimize the lateral suture stabilization technique by employing bonetobone fixation that provides implant strength and stiffness. Ac tightrope implant 18 nitinol suture passing wire required instrumentation. Followup images six weeks later showed continued improved anatomic alignment of the clavicle post tightrope fixation, with persistent widening of the ac joint fig. Early failure of coracoclavicular ligament reconstruction using. The ac tightrope enables surgeons to easily reconstruct acute ac joint separations in a minimally invasive manner, either open or arthroscopic. After approximately twenty presentations and nine hours later, fridays session ended with mr neil thomas basingstoke, uk summarising the days sessions, and paying a touching tribute to the founder and president of arthrex, reinhold schmeiding, whom he has known for over 25 years. The reconstruction technique led to favorable in vitro results with equal. Ac joint t ightr ope fixation shoulder arthroscopy. The arthrex tightrope and recently the graftrope or its many variations biotenodesis screws into coracoid have been attempted as an open or arthroscopic technique for the acute repair of ac joint separation walz et al. Acromioclavicular joint reconstruction system ar2255cgs includes. These ends are grasped and pulled down through the tibia tunnel. If ac joint tightrope variable drill guide is not available, then use of posterior cruciate ligament reconstruction tibial jig may also facilitate proper placement of the jig on the inferior surface of the. Pdf tightrope fixation of complex acromioclavicular. Do not use this device as the sole means of reconstructing a chronic acromioclavicular joint dislocation.
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