Comparison of the TightRope system versus hook plate in acute acromioclavicular joint dislocations: a retrospective analysis

Shen, Genhai; Sun, Shengxuan; Tang, Chengyang; Xie, Ye; Li, Liubing; Xu, Wei; Xu, Youjia; Zhou, Haibin

doi:10.1038/s41598-021-90989-8

Cited by 9 publications

(19 citation statements)

References 33 publications

(36 reference statements)

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“…The Rockwood classification consists of 6 categories (I–VI), and it has been stated in the literature that Type I and II injuries should be treated conservatively while Type IV to VI injuries should be treated surgically. [ 2 , 5 , 7 , 9 ] There is no optimal treatment method for type III injuries; some surgeons recommend conservative and others surgical treatment. In our study, we preferred surgical treatment for type III injuries.…”

Section: Introductionmentioning

confidence: 99%

The correlation between acromial osteolysis and acromion types in the treatment of acromioclavicular joint dislocation with hook plate

Akar

2022

Medicine

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This study aimed to radiologically evaluate the effect of hook plates used in the treatment of acromioclavicular joint (ACJ) dislocations on the development of subacromial osteolysis (SAO) according to acromion types. A total of 43 patients with mean age of 38.5 (19-77) years who were diagnosed with AC dislocation and applied neutral clavicular hook plate between 2013 and 2020 were retrospectively evaluated. Acromion types were determined by measuring acromion slope angle on lateral shoulder radiography and 3-dimensional (D)-CT of the patients. Presence of SAO was classified according to the severity of erosion in the subacromial region (grade I: minimal osteolysis, grade II: subacromial erosion <2 mm, grade III: subacromial erosion >2 mm, grade IV: cut-through of the acromion) on postoperative 3D -CT and correlation with acromion types was analyzed. Incidence of SAO was significantly higher among type 1 acromion compared to type 2 and type 3 acromion (P = .003). While osteolysis was observed in 21 patients, no osteolysis was observed in 22 patients. Osteolysis occurred in all patients with type 1 acromion, 7 patients with type 2 acromion, and 5 patients with type 3 acromion. Since the hook tip in the sagittal plane passes posterior to the center of the acromion and the concavity of the subacromial surface is inadequate in the type 1 acromion, we believe that the increased pressure applied by the hook tip on the subacromial cartilage increases the risk of SAO. We predict that the use of hook plates with an angle of 15-20 degrees, similar to the patient's AC angle, rather than neutral hook plate, will reduce the risk of osteolysis in patients with type 1 acromion.

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Section: Introductionmentioning

confidence: 99%

The correlation between acromial osteolysis and acromion types in the treatment of acromioclavicular joint dislocation with hook plate

Akar

2022

Medicine

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“…However, the treatment of type III injuries is still controversial, and most scholars still prefer surgical treatment. Currently, there are dozens of methods that can be used to treat AC dislocation, but none is considered the gold standard of treatment [4][5][6][7][8][9][10][11][12] .…”

Section: Introductionmentioning

confidence: 99%

“…In recent years, research on the surgical treatment of AC joint dislocation focused on the anatomical reconstruction of the CC ligament. Reconstruction methods include allograft ligaments, arti cial ligaments, or suspension xation devices that mimic the anatomical and biomechanical characteristics of the CC ligament [6,8,10,13]. The Tightrope is a classic technique for suspension xation devices with adjustable tension.…”

Section: Introductionmentioning

confidence: 99%

“…5 ber wire connecting the two. In recent years, this technique has been widely used in the treatment of AC joint dislocation, and has achieved satisfactory results [10,14]. Furthermore, it has been used to treat distal end of clavicle fractures [15] .…”

Section: Introductionmentioning

confidence: 99%

“…The CC ligament complex consists of the trapezium ligament and the conical ligament. The single-loop reconstruction of the conical ligament is the most widely used in the treatment of AC dislocation [10,14,17] because anatomical and biomechanical studies have con rmed that the conical ligament plays a major role in maintaining the vertical stability of the distal end of the clavicle [16]. However, in order to achieve anatomical xation, the double-loop reconstruction can theoretically provide better biomechanical stability.…”

Section: Introductionmentioning

confidence: 99%

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Single-loop and "Y"-shaped Double-loop Tightrope fixation for fresh Rockwood III-V acromioclavicular joint dislocation: an observational study lasting at least 3 years (3-6 years)

Shen

zhang

sun

et al. 2022

Preprint

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Backgrounds To compare the reduction effect of single loop and double loop in the treatment of acute acromioclavicular dislocation, postoperative complications and the effect of shoulder function recovery, so as to determine the best fixation method for acromioclavicular. Methods Patients with acute acromioclavicular dislocation treated with TightRope fixation in our hospital from January 2014 to May 2019 were reviewed. According to the different fixation methods, it can be divided into single loop group and double loop group. The difference and difference ratio of coracoclavicular spacing between the affected side and the healthy side at the 1st day, 3rd week, 6th week, 3rd month, 6th month, 1st year, 2nd year and the last follow-up were compared between the two groups, as well as the postoperative visual analog scale pain score (VAS), American Shoulder and Elbow Surgeon score(ASES) and constant-Murley score. Results On the 1st postoperative day, there was no significant difference in the reduction effect between the single loop group and the double loop group (P = 0.90,P = 0.93). 3 weeks after surgery, although the overall difference and difference rate of CCD between the two groups were different (P = 0.00,P = 0.00), there was no significant difference between type ⅲ and type ⅳ in terms of injury type (Type ⅲ P = 0.13,P = 0.16; Type ⅳ p = 0.22, p = 0.20;). Since 6 weeks after surgery, there were significant statistical differences in CCD difference rate between single loop group and double loop group. Conclusions Both single loop and double loop Tightrope can achieve satisfactory results in the treatment of fresh Rockwood ⅲ - ⅴ acromioclavicular dislocation. The single-loop group has the risk of postoperative reduction and loss.

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Acromioclavicular joint suture button repair leads to coracoclavicular tunnel widening

Dalos

Huber

Wichern

et al. 2022

Knee Surg Sports Traumatol Arthrosc

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Purpose Biomechanical evaluation of three different suture button devices used in acromioclavicular joint repair and analysis of their effect on post-testing tunnel widening. Methods Eighteen human shoulder girdles were assigned into three groups with a similar mean bone mineral density. Three different single-tunnel acromioclavicular repair devices were tested: (1) AC TightRope® with FiberWire; (2) AC Dog Bone™ Button with FiberTape; (3) Low Profile AC Repair System. Biomechanical testing was performed simulating the complex movement of the distal clavicle as follows. A vertical load of 80 N was applied continuously. The rotation of the clavicle about its long axis was set at 10° anterior and 30° posterior for 2500 cycles at 0.25 Hz. The horizontal translation of the clavicle was set at 6 mm medial and 6 mm lateral for 10,000 cycles at 1 Hz. The coracoclavicular distance was measured before and after testing. After testing, each sample underwent micro-CT analysis. Following 3D reconstruction, the area of the bone tunnels was measured at five defined cross sections. Results In TightRope® and Dog Bone™ groups, all samples completed testing, whereas in the Low Profile group, three out of six samples showed system failure. The mean absolute difference of coracoclavicular distance after testing was significantly greater in the Low Profile group compared to TightRope® and Dog Bone™ groups (4.3 ± 1.3 mm vs 1.9 ± 0.7 mm vs 1.9 ± 0.8 mm; p = 0.001). Micro-CT analysis of the specimens demonstrated significant tunnel widening in the inferior clavicular and superior coracoid regions in all three groups (p < 0.05). Conclusion Significant tunnel widening can be observed for all devices and is primarily found in the inferior parts of the clavicle and superior parts of the coracoid. The Low Profile AC Repair System showed inferior biomechanical properties compared to the AC TightRope® and AC Dog Bone™ devices. Therefore, clinicians should carefully select the type of acromioclavicular repair device used and need to consider tunnel widening as a complication.

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Comparison of the TightRope system versus hook plate in acute acromioclavicular joint dislocations: a retrospective analysis

Cited by 9 publications

References 33 publications

The correlation between acromial osteolysis and acromion types in the treatment of acromioclavicular joint dislocation with hook plate

The correlation between acromial osteolysis and acromion types in the treatment of acromioclavicular joint dislocation with hook plate

Single-loop and "Y"-shaped Double-loop Tightrope fixation for fresh Rockwood III-V acromioclavicular joint dislocation: an observational study lasting at least 3 years (3-6 years)

Acromioclavicular joint suture button repair leads to coracoclavicular tunnel widening

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