Failure of acromioclavicular reconstruction using Gore-Tex graft due to aseptic foreign-body reaction and clavicle osteolysis: A case report

Abstract

Surgical treatment for acromioclavicular (AC) joint separation can involve reduction of the joint and stabilization of the clavicle to the coracoid by use of screws, 36 Lowe G.P. Fogarty M.J. Acute acromioclavicular joint dislocation results of operative treatment with the Bosworth screw. Aust N Z J Surg. 1977; 47: 664-667 Crossref PubMed Scopus (19) Google Scholar , 50 Tsou P.M. Percutaneous cannulated screw coracoclavicular fixation for acute acromioclavicular dislocations. Clin Orthop. 1989; 243: 112-121 PubMed Google Scholar sutures, 3 Bargren J.H. Erlanger S. Dick H.M. Biomechanics and comparison of two operative methods of treatment of complete acromioclavicular separation. Clin Orthop. 1978; 130: 267-272 Crossref PubMed Scopus (51) Google Scholar , 10 Breslow M.J. Jazrawi L.M. Bernstein A.D. Kummer F.J. Rokito A.S. Treatment of acromioclavicular joint separation suture or suture anchors?. J Shoulder Elbow Surg. 2002; 11: 225-229 Abstract Full Text Full Text PDF PubMed Scopus (79) Google Scholar or synthetic materials such as polyester (Dacron, DuPont, Wilmington, DE), 12 Chen S.K. Chou P.P. Cheng Y.M. Lin S.Y. Surgical treatment of complete acromioclavicular separations. Kaohsiung J Med Sci. 1997; 13: 175-181 Google Scholar , 15 Fleming R.E. Tornberg D.N. Kiernan H. An operative repair of acromioclavicular separation. J Trauma. 1978; 18: 709-712 Crossref Scopus (28) Google Scholar , 20 Goldberg J.A. Viglione W. Cumming W.J. Waddell F.S. Ruz P.A. Review of coracoclavicular ligament reconstruction using Dacron graft material. Aust N Z J Surg. 1987; 57: 441-445 Crossref PubMed Scopus (37) Google Scholar carbon fiber, 39 Milka S. Wojcik B. Nowak R. Early results of coracoclavicular ligament reconstruction with carbon fiber prosthesis in patients with acromioclavicular dislocation. Chir Narzadow Ruchu Ortop Pol. 1994; 59 ([in Polish]): 491-496 Google Scholar and polytetrafluoroethylene (Gore-Tex; W. L. Gore Associates, Flagstaff, AZ). 56 Weinstein D.M. McCann P.D. McIlveen S.J. Flatow E.L. Bigliani L.U. Surgical treatment of complete acromioclavicular dislocations. Am J Sports Med. 1990; 18: 106-107 Crossref Scopus (11) Google Scholar The use of a Gore-Tex graft for coracoclavicular (CC) stabilization was first described by Morrison and Lemos 41 Morrison D.S. Lemos M.J. Acromioclavicular separation. Reconstruction using synthetic loop augmentation. Am J Sports Med. 1995; 23: 105-110 Crossref PubMed Scopus (110) Google Scholar in 1995 and has the proposed advantage of increased fixation strength. Although numerous reports have shown poor long-term results for Gore-Tex grafts used for anterior cruciate ligament (ACL) reconstruction, there have been no reports of failure of Gore-Tex grafts used for CC stabilization. We describe a case of a 50-year-old man who underwent AC joint reduction and stabilization with a Gore-Tex graft, which was complicated by an aseptic foreign-body reaction and distal clavicle osteolysis, resulting in failure.