• Michael Hoffmann, Malte Schroeder, Maximilian Hartel, Michael Korecki, Johannes M Rueger, Jacob V Nüchtern, Wolfgang Lehmann, and Jan P Petersen.
• Department of Trauma, Hand and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Electronic address: mi.hoffmann@uke.de.
• Arthroscopy. 2014 Aug 1;30(8):928-35.

PurposeThe 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.MethodsTen 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.ResultsSuccessful 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.ConclusionsIn 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 RelevanceLength of surgery, drilling accuracy, and reduction of radiation exposure in acromioclavicular joint reconstruction procedures affect the safety of both patients and surgeons.Copyright © 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

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