Purpose
The aim of this cadaveric study was to evaluate the accuracy, feasibility, and operation
time of a novel electromagnetic navigation system (ENS) and procedure for transclavicular-transcoracoid
tunnel placement compared with a standard minimally invasive (SMI) reconstruction
method for minimally invasive arthroscopically assisted anatomic acromioclavicular
joint reconstruction.
Methods
Ten arthroscopically assisted electromagnetic-navigated transclavicular-transcoracoid
drilling procedures and 10 SMI procedures were performed on 10 human cadavers using
2 TightRope reconstructions (Arthrex, Naples, FL) for each site. Postoperative computed
tomography scans were acquired to determine tunnel placement accuracy. Optimal coracoid
tunnel placement was defined according to the anatomic insertions of the trapezoid
and conoid ligaments with the oblong button placed in a center-base position at the
coracoid undersurface without cortical breach or fracture. Both reconstruction procedures
were performed without fluoroscopy.
Results
Successful tunnel placement was accomplished in 98.8% using the ENS method and in
83.8% using the SMI procedure (P = .087). The mean overall operation time was 28.5 ± 6.6 minutes for the ENS method
and 35.2 ± 3.9 minutes for the SMI method (P = .012). The ENS procedure required no directional readjustments or restarts. Drill
misguidance with subsequent cortical breach occurred twice in the SMI group. In both
groups no fractures were documented.
Conclusions
In this descriptive laboratory study, both the ENS and the SMI techniques achieved
the desired anatomic reconstruction. Compared with the SMI method, the ENS procedure
showed higher accuracy, required a shorter operation time, and was associated with
no complications.
Clinical Relevance
Length of surgery, drilling accuracy, and reduction of radiation exposure in acromioclavicular
joint reconstruction procedures affect the safety of both patients and surgeons.
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Article Info
Publication History
Published online: May 06, 2014
Accepted:
March 11,
2014
Received:
June 16,
2013
Footnotes
Michael Hoffmann and Malte Schroeder contributed equally and therefore share first authorship.
The authors report that they have no conflicts of interest in the authorship and publication of this article.
Identification
Copyright
© 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
