Artikel
Regeneration of the coracoacromial ligament after primary incision or resection: histological quality and clinical aspects
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Autoren
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R. Theermann
- Orthopädische Gemeinschaftspraxis und Klinik Fleetinsel, Orthopädie, Hamburg
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K. Hamper
- Hamburg
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A. Hedtmann
- Hamburg
| Veröffentlicht: | 13. Juni 2005 |
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Gliederung
Text
Question
The coracoacromial ligament (LCA) is a tension bend. By endoscopic subacromial decompression we release the LCA or do a partial resection of the LCA. How is ligament healing and histological quality after endoscopic resection of the LCA? What are the clinical consequences?
Material and method
In prospective study we resected the LCA by 61 patients with an Outlet-Impingement.
The LCA was resected in complete wide and 0,5 cm length .The mean age was 52,9 years (34 female, 27 male). In a group of 33 revisionarthroscopies (13 female, 20 male) with a mean age of 50,7 years we resected recognizable ligament reformation in all cases. The mean time between primary and secondary arthroscopy was 32 [6-84] months.
We analysed all histological specimens in serial cuts with different colourings and standardised evaluation protocol.
Results
By primary arthroscopies we found fibrous soft tissue with different degenerative changes without a specific frequent in live decadent. By secondary arthroscopies we found also fibrous soft tissue, when there were 12 months or more between primary and secondary arthroscopy. When the revision was done earlier than 12 months we found fibrous soft tissue with inflammation cells in a timely reduction after primary arthroscopy. In all cases we found a ligament reformation.
Consequences
The LCA has a biological healing potency, it is a part of the physiological ligament healing procedure. The reformation of the LCA is not a fault of the primary arthroscopy procedure. By a revision arthroscopy the ligament reformation can be released again.
