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Clinical and Radiological Outcomes of Modified Phemister Operation with Coracoclavicular Ligament Augmentation Using Suture Anchor for Acute Acromioclavicular Joint Dislocation
Clin Should Elbow 2019;22:93-99
Published online June 1, 2019;  https://doi.org/10.5397/cise.2019.22.2.93
© 2019 Korean Shoulder and Elbow Society.

Nam Su Cho, Sung Ju Bae, Joong Won Lee, Jeung Hwan Seo, Yong Girl Rhee

Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, Seoul, Korea
Correspondence to: Correspondence to: Nam Su Cho
Department of Orthopaedic Surgery, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, 892 Dongnam-ro, Gangdong-gu, Seoul 05278, Korea
Tel: +82-2-440-6154, Fax: +82-2-440-7498, E-mail: nscos1212@empas.com, ORCID: https://orcid.org/0000-0003-1643-1641
IRB approval: Kyung Hee University Hospital at Gangdong (No. KHNMC 2019-04-009).
Received April 7, 2019; Accepted April 24, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Background: Modified Phemister operation has been widely used for the treatment of acute acromioclavicular (AC) joint dislocation. Additionally, the use of suture anchor for coracoclavicular (CC) fixation has been reported to provide CC stability. This study was conducted to evaluate the clinical and radiological results of a modified Phemister operation with CC ligament augmentation using suture anchor for acute AC joint dislocation.
Methods: Seventy-four patients underwent the modified Phemister operation with CC ligament augmentation using suture anchor for acute AC joint dislocation and were followed-up for an average of 12.3 months. The visual analogue scale (VAS), range of motion, Constant score, and Korean shoulder scoring system (KSS) were used for clinical assessment. Acromioclavicular interval (ACI), coracoclavicular distance (CCD), and acromioclavicular distance (ACD) were obtained to evaluate the radiological assessments.
Results: At the last follow-up, the mean VAS Score was 1.7 points, the mean joint range of the forward flexion was 164.6째, external rotation at the side was 61.2째, and internal rotation to the posterior was a level of T12. The mean Constant score and the mean KSS was 82.7 points and 84.2 points, respectively. At the mean ACI, CCD, and ACD, significant differences were found preoperatively and at the last follow-up. When the ACI, CCD, and ACD were compared with the contralateral unaffected shoulder at the last follow-up, the affected shoulders had significantly higher values.
Conclusions: The modified Phemister operation with CC ligament augmentation using suture anchor is clinically and radiologically effective at acute AC joint dislocation.
Keywords : Shoulder; Acromioclavicular joint; Dislocation; Modified Phemister; Coracoclavicular ligament augmentation