J Korean Fract Soc.  2010 Jul;23(3):310-316. 10.12671/jkfs.2010.23.3.310.

Arthroscopic Treatment of Acromioclavicular Joint Dislocation Using TightRope(R): Preliminary Report

• Choi ES
• Park KJ
• Kim YM
• Kim DS
• Shon HC
• Cho BK
• Park JK
• Lee HC

• KMID: 1712347
• DOI: http://doi.org/10.12671/jkfs.2010.23.3.310

Abstract

PURPOSE
To evaluate the clinical and radiologic results of the arthroscopic treatment using TightRope(R) (Arthrex, Inc, Naples, FL) for management of acute acromioclavicular dislocation.
MATERIALS AND METHODS
Twelve patients with acromioclavicular joint dislocation Rockwood type V are underwent the arthroscopic acromioclavicular joint reconstruction using TightRope(R) between March, 2008 and March, 2009. The average age was 40.4 years (range 25~63 years) and mean follow-up was 10 months (range 8~16 months). The shoulders were evaluated using parameters include radiologic measurements by comparing the clavicle posteroanterior and lateral radiographs with the contralateral one. Clinical evaluation was made for pain, function, and range of joint motion by Constant score and KSS (Korean Shoulder Score).
RESULTS
All twelve patients returned to their work without pain in 3 months after operation. The average Constant score and KSS score was 98.4 (range 97~100) and 97.8 (range 97~100) at the last follow-up. Because of technical error and indication error, two patients showed failures of TightRope(R) fixation on the coracoid side and the acromioclavicular joint was redislocated, so these cases were excluded. 10 patients were satisfied with functional results and cosmetic appearance.
CONCLUSION
Considering its less morbidity, less hospitalization, excellent cosmesis, early rehabilitation, this new technique offers an attractive alternative in acromioclavicular joint stabilization if the early technical error would be overcome.

Keyword

Acromioclavicular joint; Dislocation; Arthroscopic treatment; TightRope(R)

MeSH Terms

Acromioclavicular Joint
Clavicle
Cosmetics
Dislocations
Follow-Up Studies
Hospitalization
Humans
Joints
Shoulder
Cosmetics

Figure

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  Figure 1 (A, B) Preoperative radiographs of a type V acromioclavicular dislocation (arrow). (C, D) Postoperative radiographs shows anatomical reduction of the right acromioclavicular joint using TightRope® (arrow).

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  Figure 2 (A) The base of corcacoid process is visualized with the 70 degree scope by the posterior portal. The tip of the guide pin is stopped by the drill stop at the base of the coracoid process under direct visualization. (B) Identification of the coracoid button and the security of reduction is confirmed.

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  Figure 3 (A) Postoperative 6 months later, radiograph shows the sinking of superior endobutton (arrow). (B) MRI confirms the healing of coracoclavicular ligament (arrow). (C) After removing TightRope®, photograph shows residual hole in clavicle (arrow). (D) Postoperative radiograph shows no increasement of the coracoclavicular distance (arrow).

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