Short-term clinical and radiological outcomes of treatment of acromioclavicular joint dislocations with the TightRope technique

Yıl 2021, , 327 - 330, 01.04.2021

Şahin Çepni , Mustafa Aydın

https://doi.org/10.28982/josam.893296

Öz

Background/Aim: High-grade acromioclavicular joint injuries are usually treated surgically. However, there is still no consensus on which technique should be performed. We investigated the short-term clinical and radiological outcomes of the patients treated with the TightRope technique.
Methods: In this retrospective cohort study, 15 patients (13 males and 2 females) who had an acromioclavicular joint injury and were treated with the TightRope technique between October 2015 and May 2019 were evaluated. The patients who had Rockwood type III (1 patient), type IV (8 patients), and type V (6 patients) injuries and had been followed up for at least 1 year were included in the study. At the final visits, the patients were evaluated functionally with VAS, DASH, and Constant scores, as well as radiologically by measuring the coracoclavicular distance on bilateral shoulder AP X-rays.
Results: The mean duration of follow-up was 25.2 (5.6) months. Mean time to surgery was 3.0 (2.2) days and mean time to return to work was 8.8 (1.7) weeks. The coracoclavicular distance was 11.6 (2.1) mm on the affected side and 10.2 (0.8) mm in the other shoulder. Mean VAS, DASH, and Constant scores at the final visit were 1, 10, and 92, respectively.
Conclusion: Use of the TightRope technique for the treatment of acromioclavicular dislocations might be effective like other methods that contribute to early regaining of range of motion of the shoulder joint, in addition to reduction of the dislocation.

Anahtar Kelimeler

Acromioclavicular Joint, TightRope Technique, Endobutton, Ligament Reconstruction

Kaynakça

• 1. Helfen T, Siebenbürger G, Ockert B, Haasters F. Therapy of acute acromioclavicular joint instability. Meta-analysis of arthroscopic/minimally invasive versus open procedures. Unfallchirurg. 2015;118(5):415–26. doi: 10.1007/s00113-015-0005-z
• 2. Fraser-Moodie JA, Shortt NL, Robinson CM. Injuries to the acromioclavicular joint. J Bone Joint Surg Br. 2008;90:697-707. doi: 10.1302/0301-620X.90B6.20704
• 3. Rockwood CA. Jr. Injuries to the acromioclavicular joint. In: Rockwood CA Jr, Green DP, editors. Fractures in adults. Vol 1, 2nd ed. Philadelphia: JB Lippincott; 1984;p:860–910.
• 4. Zhu L, Yang HJ, Zhao WJ, Yang WM, Zhou H. Case-control study on endobutton plate or clavicular hook plate for the repair of acromioclavicular joint dislocations. Zhongguo Gu Shang. 2012;25:120-3.
• 5. Hsu TL, Hsu SK, Chen HM, Wang ST. Comparison of hook plate and tension band wire in the treatment of distal clavicle fractures. Orthopedics. 2010;33:879. doi: 10.3928/01477447-20101021-04
• 6. Walz L, Salzmann GM, Fabbro T, Eichhorn S, Imhoff AB. The anatomic reconstruction of acromioclavicular joint dislocations using 2 Tight Rope devices: a biomechanical study. Am J Sports Med. 2008;36(12):2398–406. doi: 10.1177/0363546508322524
• 7. Costic RS, Labriola JE, Rodosky MW, Debski RE. Biomechanical rationale for development of anatomical reconstructions of coracoclavicular ligaments after complete acromioclavicular joint dislocations. Am J Sports Med. 2004;32:1929–36. doi: 10.1177/0363546504264637
• 8. Costic RS, Vangura A, Jr Fenwick JA, Rodosky MW, Debski RE. Viscoelastic behavior and structural properties of the coracoclavicular ligaments. Scand J Med Sci Sports. 2003;13:305–10. doi: 10.1034/j.1600-0838.2003.00335.x
• 9. Jensen G, Katthagen JC, Alvarado LE, Lill H, Voigt C. Has the arthroscopically assisted reduction of acute AC joint separations with the double tight-rope technique advantages over the clavicular hook plate fixation? Knee Surg Sports Traumatol Arthrosc. 2014;22(2):422–30. doi: 10.1007/s00167-012-2270-5
• 10. Stein T, Müller D, Blank M. Stabilization of acute high-grade acromioclavicular joint separation: a prospective assessment of the clavicular hook plate versus the double double-button suture procedure. Am J Sports Med. 2018;46(11):2725–34. doi: 10.1177/0363546518788355
• 11. Hemmann P, Koch M, Gühring M, Bahrs C, Ziegler P. Acromioclavicular joint separation treated with clavicular hook plate: a study of radiological and functional outcomes .Archives of Orthopaedic and Trauma Surgery. 2020;308. doi: 10.1007/s00402-020-03521-4
• 12. Martetschlager F, Kraus N, Scheibel M, Streich J, Venjakob A, Maier D. The Diagnosis and Treatment of Acute Dislocation of the Acromioclavicular Joint. Dtsch Arztebl Int. 2019;116(6):89–95. doi: 10.3238/arztebl.2019.0089
• 13. Thiel E, Mutnal A, Gilot GJ. Surgical outcome following arthroscopic fixation of acromioclavicular joint disruption with the tightrope device. Orthopedics. 2011;34(7):267-74. doi: 10.3928/01477447-20110526-11.
• 14. Motta P, Maderni A, Bruno L, Mariotti U. Suture rupture in acromioclavicular joint dislocations treated with flip buttons. Arthroscopy. 2011;27(2):294–8. doi: 10.1016/j.arthro.2010.09.009.
• 15. Pauly S, Gerhardt C, Haas NP, Scheibel M. Prevalence of concomitant intraarticular lesions in patients treated operatively for high-grade acromioclavicular joint separations. Knee Surg Sports Traumatol Arthrosc. 2009;17(5):513–7.
• 16. Darabos N, Vlahovic I, Gusic N, Darabos A, Bakota B, Miklic D. Is AC TightRope fixation better than Bosworth screw fixation for minimally invasive operative treatment of Rockwood III AC joint injury? Injury. 2015;46 Suppl 6:S1138 doi:10.1016/j.injury.2015.10.06.
• 17. Rosslenbroich SB, Schliemann B, Schneider KN, Metzlaff SL, Koesters CA, Wieaman A, et al. Minimally invasive coracoclavicular ligament reconstructionwith a flip-button technique (MINAR): clinical and radiological midterm results. Am J Sports Med. 2015;43(7):1751-7. doi: 10.1177/0363546515579179.
• 18. Scheibel M, Droschel S, Gerhardt C, Kraus N. Arthroscopically assisted stabilization of acute high-grade acromioclavicular joint separations. Am J Sports Med. 2011;39(7):1507-16.