Comparative study on the treatment of Rockwood type III acute acromioclavicular dislocation: clinical results from the Tight Rope® technique vs. K-wire fixation

• Published in: Orthopaedics & traumatology, surgery & research
• Main Authors: Horst, Klemens, MD, Garving, Christina, MD, Thometzki, Thomas, Lichte, Philipp, MD, Knobe, Matthias, MD, Dienstknecht, Thomas, MD, Hofman, Martijn, MD, Pape, Hans-Christoph, MD
• Format: Journal Article
• Language: English
• Published: 2016
• Subjects: Orthopedics; Surgery; TightRope® technique; Rockwood III follow-up; acromioclavicular joint separation; K-wire; radiological evaluation
• ISSN: 1877-0568; 1877-0568
• DOI: 10.1016/j.otsr.2016.11.009

Abstract Background and hypothesis The aim of this study was to address the inconsistency regarding the operative treatment of Rockwood type III acromioclavicular joint separation. We compared results after single- and double TightRope® reduction with results after acromioclavicular transfixation via K-wires only and additional ligament augmentation in acute acromioclavicular (AC) joint separations graded Rockwood type III, and hypothesized that the TightRope® technique leads to better clinical and radiological results. Materials &Methods We conducted a retrospective clinical cohort study and included 42 consecutive patients (mean age 43 years (24–66)) diagnosed and operatively treated between 2004 and 2012 (mean follow up was 54.6 months (15–118)). Specific shoulder scores as well as scores reflecting the patients’ over-all mental and physical health status were used. Radiological evaluation was also performed. Results The SF12 test revealed comparability between all subgroups. Specific shoulder tests and a visual analogue scale demonstrated comparable results. Radiographic measurements showed a significant reduction in the AC distance and CC distanceafter surgery in all subgroups. The early complication rate was 9.5% for all patients, while late complications occurred in 14.3% of all cases. Conclusions Compared to the established methods, the operative TightRope® procedures represent a safe alternative in Rockwood III injuries. All investigated techniques predominantly led to good and excellent clinical results in acute Rockwood type III AC joint instabilities. Avoidance of material removal and shorter hospital stays appear to speak in favour for the TightRope® technique. Level of Evidence IV