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Zürich, Switzerland

Glanzmann M.C.,Orthopadie Obere Extremitaten | Buchmann S.,Orthopadie Obere Extremitaten | Audige L.,Klinikum Rechts der Isar | Kolling C.,Orthopadie Obere Extremitaten | Flury M.,Orthopadie Obere Extremitaten
Archives of Orthopaedic and Trauma Surgery | Year: 2013

Introduction: Persistent horizontal instability after acute acromioclavicular (AC) joint separation may provoke unsatisfactory results of conservative treatment. Hypothesis: the arthroscopically assisted double flip button stabilization of acute horizontally unstable grade III and IV AC joint disruptions results in full functional restoration and stable radiological reposition. Materials: 21 patients treated for an acute grade III or IV AC joint separation were enrolled. Clinical assessment at least 2-year postoperative included the constant score (CS) and the simple shoulder test. A panorama stress view, bilateral axial view and an AC view were obtained for radiographic evaluation. Results: 19 individuals (mean 37 years; 17 men) with 16 Rockwood type III and 3 type IV injuries were available for examination 24-51 months postoperatively. The mean CS was 90.2 points (SD 6.5) with no statistically significant difference between CS and age-adjusted normative values. The mean Simple Shoulder Test scored 11.5 points (range 8-12). Loss of reduction of more than 2 mm in the coronal plane stress views was present in 6 patients (32 %) with no associated loss of functional outcome. Two of four reported complications in four patients were treated surgically (one open revision with graft augmentation for coracoid implant break out, one arthroscopic capsular release for persistent glenohumeral stiffness). Conclusion: Arthroscopically assisted double flip button stabilization for acute grade III and IV AC joint separation restores fully horizontal stability and age-expected shoulder function, resulting in high patient satisfaction, despite a loss of reduction observed radiographically in approximately one-third of patients. Level of evidence: IV. © 2013 Springer-Verlag Berlin Heidelberg. Source

Durchholz H.,Orthopadie Obere Extremitaten | Flury M.,Orthopadie Obere Extremitaten | Schwyzer H.-K.,Orthopadie Obere Extremitaten | Audige L.,Orthopadie Obere Extremitaten
Journal of Marine Science and Technology (Japan) | Year: 2015

Background: Valid comparison of outcomes of surgical procedures should include the recording and evaluation of complications. An international standard for the terminology and definitions of complications is lacking. Objective: The aim of our project is to define a minimum complication list (core set) to be applied after arthroscopic rotator cuff repair (ARCR). Materials and methods: A systematic literature review was implemented as the basis for an international consensus process. We searched for a general definition of complications and for reviews, clinical studies, and case reports focusing on ARCR. The terminology of complications and their definitions were extracted. An organized list of relevant complications was reviewed by an international panel of clinical experts in a Delphi process. Consensus was defined as at least a two-thirds agreement for groups of complications including definition, specification, and timing of occurrence. Results: A total of 242 terms for local complications after ARCR were extracted. Multiple terms described specific events. An initial list was evaluated by 59 experts. Consensus could be partly achieved. Conclusion: The literature does not consistently report on surgical complications after ARCR. Our work serves as the basis for developing a standardization of complication definitions and a uniform documentation process of complications in ARCR. A similar process is planned for complications after shoulder arthroplasty. © 2015, Springer-Verlag Berlin Heidelberg. Source

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