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


Horst, Klemens; Garving, C; Thometzki, T; Lichte, P; Knobe, M; Dienstknecht, Thomas; Hofman, M; Pape, Hans-Christoph (2017). Comparative study on the treatment of Rockwood type III acute acromioclavicular dislocation: clinical results from the TightRope(®) technique vs. K-wire fixation. Orthopaedics & Traumatology, Surgery & Research (OTSR), 103(2):171-176.

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 AND 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' overall 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 distance after 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.

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 AND 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' overall 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 distance after 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.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Department of Trauma Surgery
Dewey Decimal Classification:610 Medicine & health
Uncontrolled Keywords:Acromioclavicular joint separation, K-wire, Radiological evaluation, Rockwood III follow-up, TightRope(®) technique
Language:English
Date:April 2017
Deposited On:29 Nov 2017 15:26
Last Modified:19 Feb 2018 08:43
Publisher:Elsevier
ISSN:1877-0568
OA Status:Closed
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.1016/j.otsr.2016.11.009
PubMed ID:27940250

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