Arthroscopically guided navigation for repair of acromioclavicular joint dislocations: a safe technique with reduced intraoperative radiation exposure. Issue 1 (December 2015)

• Record Type: Journal Article
• Authors: Theopold, Jan; Marquass, Bastian; von Dercks, Nikolaus; Mütze, Maria; Henkelmann, Ralf; Josten, Christoph; Hepp, Pierre
• Is Part Of: Patient safety in surgery. Volume 9:Issue 1(2015)
• Page Start: 1
• Page End: 7
• Publication Date: 2015-12
• Subjects: Navigation -- AC joint injuries -- AC joint dislocation -- AC joint reconstruction -- Shoulder -- Coracoclavicular; Operations, Surgical -- Periodicals; Surgical errors -- Prevention -- Periodicals; 617.9
• DOI: 10.1186/s13037-015-0087-0
• Languages: English
• ISSNs: 1754-9493

Abstract

Abstract Background Accuracy evaluation of navigated image free placement of double cortical fixation buttons for coracoclavicular tunnel position in comparison to conventional drill guide based placement. Methods Twenty-six patients with acute acromioclavicular joint instability were included in this non-randomized cohort study. All patients were treated with a Double- TightRope technique. In 13 cases the conventional drill guide based placement was used (group 1). In 13 patients surgery was performed as a navigated procedure with a fluoro-free optoelectronic system (group 2). The number of coracoclavicular drillings per patient (First pass accuracy; FPA (%)) was documented, the subcoracoidal position of the fixation buttons has been evaluated and graded as "intended position achieved (IPA)" or "intended position not achieved (IPnA)". Results In group 1 drilling had to be repeated in four patients (30.8 %) to achieve proper placement of the subcoracoidal fixation buttons. 100 % first pass accuracy was observed in group 2 (p = 0.03). In group 1, the intended position of the subcoracoid buttons was not achieved (IPnA) in six patients (46.2 %). In group 2 all intended positions were achieved (p = 0.005). Conclusion Arthroscopic controlled fluoro-free navigated coracoclavicular drilling for the repair of acromioclavicular joint dislocation has higher first pass accuracy in comparison to conventional drill guide based placement. Therefore the navigation enables a precise position of the drill holes, may reduce the risk of an iatrogenic coracoid fracture and migration of fixation devices. Trial registration Local institutional review board No. 061-14-10032014