OPERATING TECHNIQUE - ACROMIOCLAVICULAR LIGAMENTOPLASTY
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Acromioclavicular Ligamentoplasty WITH ADJUSTABLE FIXATION SYSTEM

Operating Technique Acromioclavicular Ligamentoplasty The Button Loop fastening system restores the anatomy of the shoulder and especially the acromioclavicular joint in the event of acute, chronic disjunction or even fracture of the distal fourth of the clavicle. The technique is minimally invasive (possible under arthroscopic assistance, with small diameter tunnels) and simplified to make it accessible to all. Its variable length double ligament and selflocking system adapts to all morphologies of the shoulder and allows a simple assembly (direct coraco- clavicular) or «V», much more...

Operating Technique Acromioclavicular Ligamentoplasty Installation The patient will be in the beach chair position with complementary locoregional anesthesia. The arm is kept free to allow reduction at the end of the intervention, while tensioning the Button Loop; also it’s positioned on a pneumatic arm with a slight forward flexion and internal rotation to increase the volume of the future working chamber in front of the coracoid process. Voies d’abord 2 superior surgical approches: LATinc and Medinc separated by 2 cm, are made over the clavicle to perform 2 vertical tunnels. These...

Operating Technique Acromioclavicular Ligamentoplasty 1- Preparation of vertical tunnels through the clavicle 2- Opening of the rotator interval and preparation of the coracoid process This is the first stage of the operation, before any arthroscopic procedure: this allows to be more precise before the inevitable secondary swelling of the shoulder due to the arthopump. A specific guide and a 2.4 mm drill bit allows to make the two parallel, vertical and convergent tunnels, towards the coracoid process. The lateral tunnel should be positioned as close as possible to the anterior edge while...

Operating Technique Acromioclavicular Ligamentoplasty 3- Tunnel Tracking on the underside of the clavicle The dissection will then proceed to the underside of the clavicle to identify the 2 tunnels with their respective loops. The control of the medial tunnel can be dangerous because of the proximity of the sub clavian pedicle. 4- Locating the acromioclavicular joint The acromioclavicular junction should then be checked to ensure that no soft tissues are interposed, particularly in Rockwood types 4, and to achieve adequate release if necessary. We have abandoned the systematic resection of...

Operating Technique Acromioclavicular Ligamentoplasty Postoperative Follow-up A Dujarrier will be installed for 4 weeks. Pendulum exercices will begin immediately. Active range of motion will be started at the end of the first month. At 3 months, and in case of acute injury, the patient can resume all his sports activities, including contact sports. In the case of associated Weaver and Dunn procedure, contact sports can only be resumed after 9 months. It will be enough to finish the gesture by a safety knot which will asymptomatic, being located at the level of the knee of the coracoid...

Operating Technique Acromioclavicular Ligamentoplasty Chronical cases After the 10th day, it is best to combine a coracoacromial ligament graft with the previous setup. The idea is to combine the simple tunnel technique described above (located 4 cm from the acromioclavicular joint) with a second, more lateral tunnel (located 2 cm from the acromioclavicular joint) in which the coracoacromial ligament graft will be fixed and pedicled on the lateral edge of the coracoid process. A looped return around the acromion will also be associated with this to achieve horizontal acromioclavicular...

Pince tape cutter 231220FRV SIZE / COLORREFERENCE Adjustable Button Loop External Adjustable Button Loop External Titanium Shoulder Button Titanium Shoulder Button Titanium Shoulder Button Titanium Shoulder Button White / Blue White / Green 8mm - Blue 8mm - Green 10mm - Blue 10mm - Green Storage ARTHROVIMS BUTTON systems must be stored in their original undamaged packaging in a clean, dry environment at room temperature. For further information, please read the instructions for use. Products BUTTON ARTHROVIMS are packed in double sterile packaging. They are sterilised with ethylene oxide...