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3D C-arm navigated acromioclavicular joint stabilization.

Alexander Böhringer1, Florian Gebhard2, Christoph Dehner2

  • 1Department of Trauma Hand and Reconstructive Surgery, Ulm University, Albert-Einstein-Allee 23, 89081, Ulm, Germany. alexander.boehringer@uniklinik-ulm.de.

Archives of Orthopaedic and Trauma Surgery
|November 8, 2023
PubMed
Summary
This summary is machine-generated.

This study demonstrates the feasibility of using 3D digital-volume-tomography (DVT) C-arm navigation for precise implantation of suspension devices (SD) in acromioclavicular joint separations, paving the way for minimally invasive surgical techniques.

Keywords:
3D C-arm navigationAC joint separationRockwoodShoulder imagingTightropeTossy

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Area of Science:

  • Orthopedic Surgery
  • Medical Imaging Technology
  • Minimally Invasive Procedures

Background:

  • Acromioclavicular (AC) joint separations have varied surgical treatments.
  • Suspension devices (SD) are commonly used for stabilization during arthroscopic procedures.
  • There is a growing trend towards minimally invasive surgical approaches.

Purpose of the Study:

  • To investigate the feasibility and accuracy of 3D digital-volume-tomography (DVT) C-arm navigated implantation of SD.
  • To assess navigated implantation for AC joint separations using a synthetic shoulder model.
  • To evaluate the potential for minimally invasive surgical techniques in AC joint injuries.

Main Methods:

  • Implantation of a TightRope® suture button system (SD) using navigated vertical drill channels through the clavicle and coracoid.
  • Assessment of an additive horizontal suture cerclage via a navigated drill channel through the acromion.
  • Utilized 10 synthetic shoulder models with a mobile isocentric C-arm in a parasagittal position.

Main Results:

  • All vertical drill channels (Coracoclavicular, CC direction) were accurately placed centrally through the clavicle and coracoid base.
  • Horizontal drill channels (Acromioclavicular, AC direction) were precisely placed within the acromion without affecting the AC joint or lateral clavicle.
  • Successful insertion and anchoring of SD, with easy application of the horizontal AC cerclage; good image quality was achieved.

Conclusions:

  • Intraoperative 3D DVT imaging with a mobile C-arm is feasible for shoulder joints.
  • DVT-navigated SD implantation in CC and AC directions is possible on a synthetic model.
  • Further in vivo clinical studies are recommended to confirm feasibility and compare with established methods.