Comparison of hook plate with versus without double-tunnel coracoclavicular ligament reconstruction for repair of acute acromioclavicular joint dislocations: A prospective randomized controlled clinical trial

Yin, Jian; Yin, Zhaoyang; Gong, Ge; Zhu, Chao; Sun, Chao; Liu, Xinhui

doi:10.1016/j.ijsu.2018.04.017

Cited by 27 publications

(40 citation statements)

References 25 publications

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“…Yin et al reported a similar outcome following study of the use of a hook plate with or without double-tunnel coracoclavicular ligament reconstruction. In the hook plate xation alone group, six patients had loss of reduction (23.08%), and 12 patients had acromion cortex erosion, but no related complications were observed in the ligament reconstruction group [21]. In this study, we observed a similar CMS in the HM and HP groups (94.0±6.54 versus 94.2±7.35, p= 0.75); however, the grade of loss of reduction was better in the HM group 12 months after surgery (100.75±48.70 versus 91.47±27.47, p= 0.015), indicating that the HM group exhibited superior reduction maintenance over the HP group.…”

Section: Discussionmentioning

confidence: 92%

Is coracoclavicular reconstruction necessary in hook plate fixation for acute unstable acromioclavicular dislocation?

Chen

Jhan

et al. 2020

Preprint

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Background Acromioclavicular joint (ACJ) dislocation is a relatively common shoulder injury. For the treatment of cases of severe ACJ dislocation (Rockwood type III–V), hook plate fixation is an easy-to-master and minimally-invasive approach to surgical intervention. Overstress on the acromion following hook plate fixation often leads to acromial complications such as osteolysis and loss of reduction. We hypothesized that suspensory reconstruction alongside hook plate fixation might provide a superior stability and reduce complications as compared with hook plate fixation alone. The purpose of the study was to assess the clinical and radiographic outcomes of these two surgical modalities. Methods We retrospectively enrolled 38 patients with acute ACJ dislocation from May 2010 to December 2018. Among them, nineteen patients received hook plate fixation only (HP group), and 19 underwent concomitant hook plate fixation and loop suspension fixation with two mersilene sutures (HM group). The demographic data of the patients were recorded and analyzed. All patients underwent a shoulder x-ray initially, immediately postoperatively, and at 1, 3, 6 and 12 months to measure the relative coracoclavicular distance (rCCD). Clinical assessment of shoulder function outcome was conducted using the Constant Murley Score (CMS); the University of California at Los Angeles (UCLA) Shoulder Score was also measured at the latest follow-up. Results There were no significant differences in the demographic data between the two groups. With regards to the CMS and the UCLA score, the HM group and HP group both had excellent outcomes, and no significant differences in scores were observed between groups (CMS: 93.90 ± 6.16 versus 94.47 ± 7.26, p = 0.47; UCLA score: 32.84 ± 2.91 versus 34.32 ± 1.16, p = 0.07). However, the HM group demonstrated substantial superiority in terms of maintenance of the rCCD over the HP group (91.47 ± 27.47 versus 100.75 ± 48.70, p = 0.015). In addition, there was less subacromial osteolysis in the HM group than the HP group (52.6% versus 15.8%, p = 0.038). Conclusion Concomitant hook plate fixation with loop suspensory reconstruction yielded excellent functional outcomes and superior maintenance of the rCCD with fewer acromion complications than hook plate fixation alone.

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Section: Discussionmentioning

confidence: 92%

Is coracoclavicular reconstruction necessary in hook plate fixation for acute unstable acromioclavicular dislocation?

Chen

Jhan

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Yin et al reported a similar outcome following study of the use of a hook plate with or without double-tunnel coracoclavicular ligament reconstruction. In the hook plate xation alone group, six patients had loss of reduction (23.08%), and 12 patients had acromion cortex erosion, but no related complications were observed in the ligament reconstruction group [21]. In this study, we observed a similar CMS in the HM and HP groups (94.0±6.54 versus 94.2±7.35, p= 0.75); however, the grade of loss of reduction was better in the HM group 12 months after surgery (100.75±48.70 versus 91.47±27.47, p= 0.015), indicating that the HM group exhibited the statistical differences in reduction maintenance over the HP group.…”

Section: Discussionmentioning

confidence: 92%

Is coracoclavicular reconstruction necessary in hook plate fixation for acute unstable acromioclavicular dislocation?

Chen

Jhan

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Acromioclavicular joint (ACJ) dislocation is a relatively common shoulder injury. For the treatment of cases of severe ACJ dislocation (Rockwood type III–V), hook plate fixation is a neasy-to-master and minimally-invasive approach to surgical intervention. Over stress on the acromion following hook plate fixation often leads to acromial complications such as osteolysis and loss of reduction. We hypothesized that suspensory reconstruction a longside hook plate fixation might provide a superior stability and reduce complications as compared with hook plate fixation alone. The purpose of the study was to assess the clinical and radiographic outcomes of these two surgical modalities.Methods: We retrospectively enrolled 49 patients with acute ACJ dislocation from May 2010 to December 2018. Among them, nineteen patients received hook plate fixation only (HP group), and 19 underwent concomitant hook plate fixation and loop suspension fixation with two mersilene sutures (HM group). The demographic data of the patients were recorded and analyzed. All patients underwent a shoulder x-ray initially, immediately postoperatively, and at 1, 3, 6 and12 months to measure the relative coracoclavicular distance (rCCD). Clinical assessment of shoulder function outcome was conducted using the Constant Murley Score (CMS); the University of California at Los Angeles (UCLA) Shoulder Score was also measured at the latest follow-up.Results: There were no significant differences in the demographic data between the two groups. With regards to the CMS and the UCLA score, the HM group and HP group both had excellent outcomes, and no significant differences in scores were observed between groups (CMS: 93.90±6.16 versus 94.47±7.26, p=0.47; UCLA score: 32.84±2.91 versus 34.32±1.16, p=0.07). However, the HM group demonstrated substantial superiority in terms of maintenance of the rCCD over the HP group (91.47±27.47 versus 100.75±48.70, p=0.015). In addition, there was less subacromial osteolysis in the HM group than the HP group (52.6% versus 15.8%, p=0.038).Conclusion: Both fixations yielded excellent functional outcomes. However, concomitant hook plate fixation with loop suspensory reconstruction demonstrated the fewer acromion complications and statistical differences in reduction maintenance with less clinical significance.

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“…However, hook plates may be combined with ligament reconstruction. For example, Yin et al concluded that hook plating combined with a double-tunnel CC reconstruction showed superior results to hook plating alone [20]. Although hook plate osteosynthesis is a simple procedure, a second procedure for hardware removal is required.…”

Section: Discussionmentioning

confidence: 99%

Different treatment strategies for acromioclavicular dislocation injuries: a nationwide survey on open/minimally invasive and arthroscopic concepts

et al. 2019

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BackgroundInjuries to the acromioclavicular (AC) joint are one of the most common among sporting injuries of the upper extremity. Several studies investigated different treatment options comparing surgical and non-surgical treatment, and type of operative interventions. This study aims to evaluate treatment decisions regarding injuries of the AC joint and to compare different treatment strategies depending on the specific training of the treating physician.MethodsWe performed a nationwide survey by contacting different experienced physicians and sending them questionnaires. The questionnaire included 37 questions that assessed preferred treatment strategies in AC joint injuries. We addressed different surgical and nonsurgical options as well as level of experience and factors that might influence the decision on treatment strategy. The physicians were stratified according to their training into general surgeons (group trauma associated) and orthopedic surgeons (orthopedic associated). The AC joint lesions were categorized according to the widely used Rockwood classification.ResultsThis study analyses 96 questionnaires. We included 46 (47.9%) colleagues in group trauma and 50 (52.1%) in group orthopedics. Most of the colleagues (98.9%) prefer non-operative treatment of type I and type II AC lesions. Similarly, 96.8% agree on surgical treatment of types IV, V, and VI lesions. The treatment of type III lesions is performed in 41.6% of cases non-operatively and in 58.4% of cases surgically. Trauma-associated colleagues are 3.4 times more likely to treat AC lesions with a hook plate compared to orthopedic-associated colleagues (p = 0.05). In decreasing order, the most commonly used non-surgical technique is sling immobilization (63.7%), and the most commonly performed surgical treatment is the hook plate (41.1%) in treating type III injuries.ConclusionThis study shows a distinct difference in treatment of AC joint injuries depending on the training of the physician. Further, the need for high-quality studies arises to define the optimal treatment of type III lesions.

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Comparison of hook plate with versus without double-tunnel coracoclavicular ligament reconstruction for repair of acute acromioclavicular joint dislocations: A prospective randomized controlled clinical trial

Abstract: The overall surgical effect of the use of a hook plate combined with double-tunnel CC ligament reconstruction is superior to single hook plate surgery for the repair of acute Rockwood type III and V AC joint dislocations.

Cited by 27 publications

References 25 publications

Is coracoclavicular reconstruction necessary in hook plate fixation for acute unstable acromioclavicular dislocation?

Is coracoclavicular reconstruction necessary in hook plate fixation for acute unstable acromioclavicular dislocation?

Is coracoclavicular reconstruction necessary in hook plate fixation for acute unstable acromioclavicular dislocation?

Different treatment strategies for acromioclavicular dislocation injuries: a nationwide survey on open/minimally invasive and arthroscopic concepts

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