UK
Xiros USATLC for the ACJ
Infinity-Lock Button System for reduction of acromioclavicular (AC) separations
Successful operative treatment of the acromioclavicular joint (ACJ) requires a meticulous technique.
Meta-analysis has found that using a loop around the coracoid, as opposed to drilling through the bone, results in a lower incidence of re-operation as well as fewer failures in chronic injuries1. The Infinity-Lock Button system provides good clinical and radiological outcomes in treating acromioclavicular joint separation, with its broad tape looping around the coracoid and passing through the clavicle vertically with low-profile fixation.
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Benefits
Infinity-Lock Button System is designed to enable meticulous care of the tissue structures in the shoulder.
- No drill hole through the delicate coracoid, reducing risk of fracture
- Instrumentation: CC-Hook dedicated coracoid passer for minimal soft-tissue damage
- Broad tape for reduced likelihood of bone abrasion
- 4 mm clavicle vertical tunnel, no A-P drilling
The tape construct has an open-weave structure, facilitating tissue in-growth and on-growth. Tissue graft augmentation can be used but is not needed, eliminating autograft morbidity and allograft cost issues.
The one-size-fits-all design and single-use instrument reduce inventory and instrument-kit complexity as well as eliminating the risk of mis-sizing.
- Studies show good clinical and radiological outcomes
- Pain reduction, anatomic shoulder reduction and enabling return to work or sport
- The device has low stretch and maintains high strength under repeated long-term loading
Please also refer to the animation and surgical technique manual.
- The implant is passed around the coracoid process and both limbs are passed through the loop
- Both limbs of the Tape are passed through the 4 mm diameter bone tunnel one at a time
- Single low-profile Button is used to anchor the Tape to the bone
- Secured with a surgeon’s knot posteriorly
There are several studies on the Infinity-Lock Button System, from different centres, all with excellent results. Download summary of clinical data.
- Series of 15 patients, Rockwood Grade III AC joint dislocations, 18 month follow-up2
- Series of 15 patients, Rockwood Grade IV, V acute and Grade III chronic, controlled, followed for minimum 3 months3
- Series of mixed grade AC joint dislocations, 15 cases4
The studies used different function scoring systems but showed good improvement. Romano et al2 reported CMS scores of 95 at 18-month follow-up. Loukovitis et al3 used the Nottingham clavicle score, the patients treated with Infinity-Lock Button System had a mean score of 80 at follow-up, the control group score was 69. Chowdhury et al4 used the Oxford score, recording 40.5 (maximum 48) improved from 16.2 pre-operatively (no control group).
Two studies also measured the reduction, with 7.4 mm and 8.2 mm mean reductions in clavicle-coracoid distance. There were only two instances of loss of reduction in the 45 cases across all three reports.
Indications
The Infinity-Lock Button System is indicated for patients with acromioclavicular separations resulting from disruption to the coracoclavicular ligaments.
Instructions for Use
To view the instructions for use please visit our IFU library
Ordering Codes
102-1089 Infinity-Lock Button System, includes:
Infinity-Lock Tape, 7 mm x 240 mm
Infinity-Lock Button, 4 mm x 12 mm
Cannulated drill bit, plain shank to fit Jacobs Chuck, 4.0 mm diameter x 120 mm
Guidewire, 2.0 mm diameter x 150 mm
Optional Disposable Instrument:
202-1411 CC-Hook, with a curved end, Left
202-1413 CC-Hook, with a curved end, Right
Frequently Asked Questions
Do I need to buy or loan an instrument set?
There is no instrument set required. The drill and guidewire are supplied with the implant. The CC-Hook coracoid passer (left or right shoulder version) is supplied separately as a single-use instrument.
Is there a knot stack on top of the button on the clavicle?
No, the tapes are passed from the button around the clavicle and tied posteriorly, where the depth of tissue between clavicle and skin is greater. Optionally the surgeon can tie a half knot over the button for stability while completing this final step.
Are there any special rehabilitation requirements?
There is a recommended rehabilitation programme. This should be supervised by a physiotherapist. All mobilisation and exercises should be performed within the pain free range of movement. The patient should be warned not to exceed the prescribed activity levels or to overload the repair before complete healing has occurred.
What happens to the Infinity-Lock tape over time?
The tape is non-resorbable polyester and stays in place. The open weave provides a scaffold construction which allows tissue on-growth and in-growth, leading to encapsulation of the tape.
How can the reduction with the Infinity-Lock Button System be reliable?
There are key elements of the surgical technique that are highlighted in training for reliable reduction and best positioning. For example, there is guidance on selecting the optimum drill position on the clavicle. These are covered in the training material for the procedure.
How can I obtain training on the technique?
Xiros run periodic training courses and have access to a range of training material. Depending on location and situation, we may also be able to connect you with a surgeon who uses Infinity-Lock Button System. Please contact us to discuss your requirements.
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Additional Information
For further information, and for details of local distributors and agents, contact our Sales and Marketing team at enquiries@xiros.co.uk
All data listed on this page is held at Xiros and can be requested by contacting enquiries@xiros.co.uk
To request the full range of product documentation or to view any of these documents in a language other than English, please contact us for availability
Always refer to the Instructions for Use which contains detailed information and essential warnings and precautions
- Chowdhury A, Hillier-Smith R, MacLeod I, Colaço H. Coracoid tunnel versus coracoid loop techniques for acromioclavicular stabilisation: a systematic review. Poster, London Shoulder Meeting 2023.
- Romano, A. M., P. Casillo, M. De Simone, G. Nastrucci, D. Risorto, M. Susanna, A. Di Giunta and F. Ascione (2020). The Infinity-Lock System for Chronic Grade III AC Joint Dislocation: A Novel Technique, Rehabilitation Protocol and Short Term Results. J Clin Med 9(8).
- Loukovitis K, Dupley L, Sharma S, Heasley R, Jain N. A Comparison Study of the Clinical and Radiographic Outcomes of Two Techniques of Coraco-Clavicular Ligament Reconstruction for Acromioclavicular Joint. EFORT Congress, Lisbon 2019.
- Chowdhury A, Kohli S, Taiwo A, Sampalli S, Elmorsy A. Clinical and radiological outcomes of the Xiros Infinity-Lock Button System, a novel suture button technique, for the management of Acromioclavicular joint disruption. EFORT Congress, Lisbon 2019.