Chronic acromioclavicular dislocations: multidirectional stabilization without grafting

• Published in: JSES international Vol. 4; no. 3; pp. 519 - 531
• Main Authors: Cano-Martínez, José Antonio, Nicolás-Serrano, Gregorio, Bento-Gerard, Julio, Marín, Francisco Picazo, Grau, Josefina Andres, Antón, Mario López
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2020; Elsevier
• Subjects: Acromioclavicular joint; anatomic reconstruction; chronic dislocation; horizontal stability; minimally invasive surgery; Shoulder; Twin Tail TightRope technique; Treatment Study; Level IV; chronic dislocation; anatomic reconstruction; minimally invasive surgery; Case Series; Twin Tail TightRope technique; horizontal stability; Acromioclavicular joint
• ISSN: 2666-6383; 2666-6383
• DOI: 10.1016/j.jseint.2020.04.014

Clinical and radiological evaluation of the surgical treatment of chronic acromioclavicular (AC) dislocations with triple button device and AC joint augmentation. This retrospective study included 21 patients with chronic AC dislocations. All patients underwent bilateral-weighted Zanca and Alexander views as well as the Constant score (CS) and Acromioclavicular Joint Instability Scoring System (ACJI). A total of 21 patients (19 men and 2 women) with the mean age of 30.7 ± 11.7 years (range, 19-62 years) were able to participate in clinical and radiographic follow-up. After a mean follow-up of 49.7 ± 17.1 months (range, 13-60 months), the results of the CS were 95.2 ± 5.5 (range, 85-100) and ACJI test 89.7 ± 7.9 (range, 75-100), showing no significant differences with the uninjured shoulder (CS, 96.2 ± 3.9; range, 85-100; ACJI, 95.7 ± 4.1; range, 85-100). At the final review, we observed that the preoperative coracoclavicular distance (Zanca view) improved from 12.8 ± 1.5 mm to 8.5 ± 1.3 mm and the AC distance (Alexander view) from 7.8 ± 2.3 mm to 0.99 ± 0.91 mm. Compared with healthy shoulder, these differences were not significant. Osteoarthritis or radiological calcifications were not associated with worse clinical outcomes. The triple button device is an acceptable alternative surgical method for chronic AC joint dislocations. The surgical technique is simple; it does not need a graft, nor does it present major complications, and material extraction is unnecessary.