J Korean Fract Soc.  2017 Jan;30(1):16-23. 10.12671/jkfs.2017.30.1.16.

A Comparison of Results between AO Hook Plate and TightRope for Acute Acromioclavicular Joint Dislocation

Affiliations
  • 1Department of Orthopedic Surgery, CHA Gumi Medical Center, CHA University, Gumi, Korea. osjmdan@gmail.com

Abstract

PURPOSE
The purpose of our study is to compare the radiographic and clinical outcomes with respect to acromioclavicular (AC) joint dislocation depending on the surgical method: Hook plate (HP) versus TightRope (TR).
MATERIALS AND METHODS
Between May 2009 and May 2012, 51 patients with Rockwood type III-V lesions received clinical and radiographic follow-up. Patients were divided into two groups according to the surgical methods (HP: n=32; TR: n=19). Radiological follow-up included comparative coracoclavicular distance (CCD) measurements as a percentage of the uninjured shoulder. For clinical follow-up, a standardized functional shoulder assessment with the Constant score, University of California at Los Angeles (UCLA) score, and Korea shoulder score (KSS) were carried out.
RESULTS
Comparing the functional results, no differences were observed between the two groups (Constant score: HP, 78.5; TP, 81.4; UCLA score: HP, 29.2; TP, 29.9; KSS: HP, 79.2; TP, 80.7). Time to restoration of the range of motion (ROM) above shoulder level was longer in the HP group than in the TR group. However, the ROM at 1 year postoperation and final follow-up revealed similar results between the two groups. The AC joints were well reduced in both groups, the CCD increased to 44.7% in the HP group and to 76.5% in the TR group at the final follow-up; however, no one was significantly superior to the others. Furthermore, there were 8 cases (25.0%) and 5 cases (26.3%) of AC joint arthritis in the HP group and TR group, respectively. However, the observed AC joint arthritis has a poor correlation between clinical symptom and radiological results in both groups.
CONCLUSION
Both HP and TR fixation could be a recommendable treatment option in acute unstable AC joint dislocation. Both groups showed excellent radiologic and functional results at the final visit. Moreover, there was no significant difference in statistics, except for the time to restoration of ROM above shoulder level.

Keyword

Acute acromioclavicular joint dislocation; Hook plate; TightRope

MeSH Terms

Acromioclavicular Joint*
Arthritis
California
Dislocations*
Follow-Up Studies
Humans
Joints
Korea
Methods
Range of Motion, Articular
Shoulder

Figure

  • Fig. 1 (A) Surgical exposure. (B) Postoperative X-ray, Hook plate. (C) Postoperative X-ray, TightRope.

  • Fig. 2 Final coracoclavicular distance (↕). (A) Pre-implant removal, (B) Post-implant removal.

  • Fig. 3 Postoperative acromioclavicular joint arthritic changes were seen at the final follow-up radiography (dotted circles). (A) Hook-plate. (B) TightRope.


Reference

1. Mazzocca AD, Arciero RA, Bicos J. Evaluation and treatment of acromioclavicular joint injuries. Am J Sports Med. 2007; 35:316–329.
Article
2. Rockwood CA Jr, Williams GR Jr, Young DC. Disorders of the acromioclavicular joint. In : Rockwood CA, Matsen FA, editors. The shoulder. 2nd ed. Philadelphia (PA): WB Saunders;1998. p. 483–553.
3. Simovitch R, Sanders B, Ozbaydar M, Lavery K, Warner JJ. Acromioclavicular joint injuries: diagnosis and management. J Am Acad Orthop Surg. 2009; 17:207–219.
Article
4. Gstettner C, Tauber M, Hitzl W, Resch H. Rockwood type III acromioclavicular dislocation: surgical versus conservative treatment. J Shoulder Elbow Surg. 2008; 17:220–225.
Article
5. Cote MP, Wojcik KE, Gomlinski G, Mazzocca AD. Rehabilitation of acromioclavicular joint separations: operative and nonoperative considerations. Clin Sports Med. 2010; 29:213–228. vii
Article
6. Galpin RD, Hawkins RJ, Grainger RW. A comparative analysis of operative versus nonoperative treatment of grade III acromioclavicular separations. Clin Orthop Relat Res. 1985; (193):150–155.
Article
7. Spencer EE Jr. Treatment of grade III acromioclavicular joint injuries: a systematic review. Clin Orthop Relat Res. 2007; 455:38–44.
8. Jerosch J. The acromioclavicular joint. Orthopade. 2000; 29:895–908.
9. von Heideken J, Boström Windhamre H, Une-Larsson V, Ekelund A. Acute surgical treatment of acromioclavicular dislocation type V with a hook plate: superiority to late reconstruction. J Shoulder Elbow Surg. 2013; 22:9–17.
Article
10. Tauber M. Management of acute acromioclavicular joint dislocations: current concepts. Arch Orthop Trauma Surg. 2013; 133:985–995.
Article
11. Henkel T, Oetiker R, Hackenbruch W. Treatment of fresh Tossy III acromioclavicular joint dislocation by ligament suture and temporary fixation with the clavicular hooked plate. Swiss Surg. 1997; 3:160–166.
12. Eschler A, Gradl G, Gierer P, Mittlmeier T, Beck M. Hook plate fixation for acromioclavicular joint separations restores coracoclavicular distance more accurately than PDS augmentation, however presents with a high rate of acromial osteolysis. Arch Orthop Trauma Surg. 2012; 132:33–39.
Article
13. Cho CH, Sohn SW, Kang CH, Oh GM. Coracoclavicular ligament augmentation using tightrope for acute acromioclavicular joint dislocation: surgical technique and preliminary results. J Korean Shoulder Elbow Soc. 2008; 11:165–171.
Article
14. Ejam S, Lind T, Falkenberg B. Surgical treatment of acute and chronic acromioclavicular dislocation Tossy type III and V using the Hook plate. Acta Orthop Belg. 2008; 74:441–445.
15. Andreani L, Bonicoli E, Parchi P, Piolanti N, Michele L. Acromio-clavicular repair using two different techniques. Eur J Orthop Surg Traumatol. 2014; 24:237–242.
Article
16. An WJ, Sun JB, Ye P, Guo WW. Comparative study on the treatment of acromioclavicular joint dislocation: coracoclavicular ligament reconstruction combined with hook plate fixation or suture-anchor fixation. Zhonghua Wai Ke Za Zhi. 2013; 51:349–353.
17. Charity RM, Haidar SG, Ghosh S, Tillu AB. Fixation failure of the clavicular hook plate: a report of three cases. J Orthop Surg (Hong Kong). 2006; 14:333–335.
Article
18. Jafary D, Keihan Shokouh H, Najd Mazhar F, Shariat Zadeh H, Mochtary T. Clinical and radiological results of fixation of acromioclavicular joint dislocation by hook plates retained for more than five months. Trauma Mon. 2014; 19:e13728.
Article
19. Shaffer BS. Painful conditions of the acromioclavicular joint. J Am Acad Orthop Surg. 1999; 7:176–188.
Article
20. McConnell AJ, Yoo DJ, Zdero R, Schemitsch EH, McKee MD. Methods of operative fixation of the acromio-clavicular joint: a biomechanical comparison. J Orthop Trauma. 2007; 21:248–253.
Article
21. Chen CH, Dong QR, Zhou RK, Zhen HQ, Jiao YJ. Effects of hook plate on shoulder function after treatment of acromioclavicular joint dislocation. Int J Clin Exp Med. 2014; 7:2564–2570.
22. ElMaraghy AW, Devereaux MW, Ravichandiran K, Agur AM. Subacromial morphometric assessment of the clavicle hook plate. Injury. 2010; 41:613–619.
Article
23. Fung M, Kato S, Barrance PJ, et al. Scapular and clavicular kinematics during humeral elevation: a study with cadavers. J Shoulder Elbow Surg. 2001; 10:278–285.
Article
24. Wellmann M, Zantop T, Petersen W. Minimally invasive coracoclavicular ligament augmentation with a flip button/polydioxanone repair for treatment of total acromioclavicular joint dislocation. Arthroscopy. 2007; 23:1132.e1–1132.e5.
Article
25. Chernchujit B, Tischer T, Imhoff AB. Arthroscopic reconstruction of the acromioclavicular joint disruption: surgical technique and preliminary results. Arch Orthop Trauma Surg. 2006; 126:575–581.
Article
26. Cutbush K, Hirpara KM. All-arthroscopic technique for reconstruction of acute acromioclavicular joint dislocations. Arthrosc Tech. 2015; 4:e475–e481.
Article
27. Bajnar L, Bartoš R, Sedivý P. Arthroscopic stabilisation of acute acromioclavicular dislocation using the TighRope device. Acta Chir Orthop Traumatol Cech. 2013; 80:386–390.
Full Text Links
  • JKFS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr