Journal: Arthroscopy Techniques
Article Title: Two Scope Portals in Simple Acromioclavicular Joint Type III Injury
doi: 10.1016/j.eats.2025.103536
Figure Lengend Snippet: Intraoperative photographs detailing minimally invasive arthroscopic treatment of isolated Rockwood type III acute acromioclavicular dislocation in left shoulder of male patient via Dog Bone Button. The arthroscopic steps are as follows: (A) Through the anterolateral portal, the inferior surface of the coracoid is visualized. By use of the Serfas vaporizer instrument introduced through the anteroinferior portal, the inferior surface is skeletonized, exposing it as much as possible. (B) Visualization of inferior surface of coracoid from anteroinferior portal. (C) Visualization of inferior surface of coracoid from anteroinferior portal, followed by skeletonization of inferior surface using Serfas vaporizer instrument through anterolateral portal. (D) Visualization of inferior surface of coracoid from anteroinferior portal, with skeletonization of inferior surface using 4.0-mm powered shaver (Stryker) through anterolateral portal. (E) Palpation of medial margin of coracoid with probe (Stryker) introduced through anterolateral portal, with visualization from anteroinferior portal. (F) Palpation of medial margin of coracoid using the extremity of acromion Arthrex compass at 90° angle through anterolateral portal, with visualization from anteroinferior portal. (G) Visualization of drill insertion from anteroinferior portal, performed with Arthrex compass and drill, both introduced through anterolateral portal. (H) Passage of SutureLasso SD Wire Loop through Arthrex cannulated drill, visualized from anterolateral portal. (I) Retrieval of SutureLasso SD Wire Loop from Arthrex cannulated drill, correctly positioned at inferior surface of coracoid base. This is visualized from the anterolateral portal, and retrieval is performed with an arthroscopic grasper (Stryker) through the anteroinferior portal. (J) After loading the 2 FiberTape sutures of the Dog Bone Button onto the SutureLasso, the SutureLasso is retrieved, thereby pulling the 2 FiberTape sutures of the Dog Bone Button through the coracoid. This step is visualized from the anterolateral portal, with the FiberTape sutures being inserted through the anteroinferior portal. (K) Visualization of Dog Bone Button in vertical position on inferior surface of coracoid from anterolateral portal. (L) Visualization of Dog Bone Button properly positioned at inferior surface of coracoid base from anterolateral portal.
Article Snippet: The trocar is removed from the drill, and a SutureLasso SD Wire Loop (Arthrex) is passed through the drill cannulation loop and then retrieved through the anteroinferior portal, viewing through the anterolateral portal.
Techniques: Isolation