Jeung Yeol Jeong, M. D. , Yon-Sik Yoo, M. D. , Ph. D

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Presentation transcript:

Arthroscopic Coracoclavicular Fixation Technique Using Multiple All-Suture Anchors Jeung Yeol Jeong, M.D., Yon-Sik Yoo, M.D., Ph.D., Seung-Jin Lee, M.D., Wooyoung Im, M.D. Arthroscopy Techniques Volume 8, Issue 4, Pages e423-e427 (April 2019) DOI: 10.1016/j.eats.2018.12.002 Copyright © 2019 Arthroscopy Association of North America Terms and Conditions

Fig 1 Overview of operating site. Left shoulder, lateral decubitus position. Standard posterior, anterolateral, and anterior portals and an additional skin incision over the distal clavicle are used. Arthroscopy Techniques 2019 8, e423-e427DOI: (10.1016/j.eats.2018.12.002) Copyright © 2019 Arthroscopy Association of North America Terms and Conditions

Fig 2 Subacromial space view of a left shoulder, through the anterolateral viewing portal, with the patient in the lateral decubitus position. The coracoid base is exposed by performing bursectomy using an ArthroCare device (ArthroCare, Autsin, TX) along the coracoacromial ligament. The subscapularis muscle is observed under the coracoid base. Arthroscopy Techniques 2019 8, e423-e427DOI: (10.1016/j.eats.2018.12.002) Copyright © 2019 Arthroscopy Association of North America Terms and Conditions

Fig 3 Outer view of trans-clavicular trans-coracoid drilling (with anterolateral portal as viewing portal and anterior portal as working portal). Arthroscopy Techniques 2019 8, e423-e427DOI: (10.1016/j.eats.2018.12.002) Copyright © 2019 Arthroscopy Association of North America Terms and Conditions

Fig 4 Subacromial space view through the anterolateral portal. Trans-clavicular trans-coracoid drilling is performed through the AC TightRope guide (asterisk) into the anterior portal to create the first tunnel. Arthroscopy Techniques 2019 8, e423-e427DOI: (10.1016/j.eats.2018.12.002) Copyright © 2019 Arthroscopy Association of North America Terms and Conditions

Fig 5 Subacromial space view through the anterolateral portal. The nitinol suture-passing wire is inserted into the first tunnel to shuttle relay the Y-Knot limbs. A retriever (asterisk) is used to pull the nitinol suture-passing wire out of the anterior portal. Arthroscopy Techniques 2019 8, e423-e427DOI: (10.1016/j.eats.2018.12.002) Copyright © 2019 Arthroscopy Association of North America Terms and Conditions

Fig 6 Subacromial space view through the anterolateral portal. The first knot is anchored under the base of the coracoid process. Arthroscopy Techniques 2019 8, e423-e427DOI: (10.1016/j.eats.2018.12.002) Copyright © 2019 Arthroscopy Association of North America Terms and Conditions

Fig 7 Subacromial space view through the anterolateral portal. The 3 knots are anchored under the base of the coracoid process. Arthroscopy Techniques 2019 8, e423-e427DOI: (10.1016/j.eats.2018.12.002) Copyright © 2019 Arthroscopy Association of North America Terms and Conditions

Fig 8 Outer view of an oversized, giant knot made by placing 6 subsequent half-hitches on either side of the existing knots just before the reduction. Arthroscopy Techniques 2019 8, e423-e427DOI: (10.1016/j.eats.2018.12.002) Copyright © 2019 Arthroscopy Association of North America Terms and Conditions