TY - JOUR
T1 - Comparison of hook plate alone, hook plate augmented with suture anchor, and arthroscopically-assisted tightrope fixation in the treatment of patients with acute type v acromioclavicular joint dislocations
AU - Sheu, Huan
AU - Weng, Chun Jui
AU - Tang, Hao Che
AU - Yang, Cheng Pang
AU - Hsu, Kuo Yao
AU - Chan, Yi Sheng
AU - Chao-Yu Chen, Alvin
AU - Chih-Hao Chiu, Joe
N1 - Copyright © 2022 Elsevier Masson SAS. All rights reserved.
PY - 2023/6
Y1 - 2023/6
N2 - INTRODUCTION: The best treatment for Rockwood type V acromioclavicular (AC) joint dislocation is unknown.HYPOTHESIS: Hook plate augmented with suture anchor (HA) may have different clinical and radiological results than hook plate alone (H), and arthroscopically assisted TightRope (TR) techniques in treating acute type V AC joint dislocations.MATERIAL AND METHODS: This retrospective study included 71 patients with acute type V AC joint dislocations between December 2010 and August 2018. Patients were categorized into three groups: H group (n=22), HA group (n=23) and TR group (n=26). We measured the coracoclavicular distance (CCD) differences and CCD ratio compared to uninjured side pre-operatively, immediately post-operatively, at 3-month and 2-year after operation. Clinical outcomes were assessed as well at the same time points. Loss of correction was determined by the CCD difference and ratio between surgical and uninjured sides.RESULTS: The mean age and follow-up period were 41.8±24.7 years and 30.2±4.3 months, respectively. No significant differences were found in the demographic data between the three groups. The HA group presented a trend of less overcorrection but without significance compared with the H group at immediately post-operation, 3-month, and 2-year follow-up. (CCD difference: -2.4mm vs. -3.7mm, -1.6mm vs. -1.8, and 0.2mm vs -1.9mm, CCD ratio: 67.7% vs. 40.9%, 79.3% vs. 70.1%, and 100.6% vs. 86.5%, respectively). The HA group also had significantly less loss of correction compared with the TR group at 3-month and 2-year after the operation (CCD difference: -1.6mm vs. 1.6mm, 0.2mm vs. 2.4mm; CCD ratio: 79.3% vs. 122.2%, 100.6% vs. 136.1%, all p<0.05). All three methods achieved significant improvement in function and pain without inter-group differences. No coracoid-related or tunnel complications occurred.DISCUSSION: The hook plate alone, and hook plate with suture anchor augmentation techniques provided less residual vertical instability compared to TightRope fixation at 2-year follow-up. The patient-reported functional outcomes were promising and comparable among the three groups.LEVEL OF EVIDENCE: III, Retrospective comparative therapeutic trial.
AB - INTRODUCTION: The best treatment for Rockwood type V acromioclavicular (AC) joint dislocation is unknown.HYPOTHESIS: Hook plate augmented with suture anchor (HA) may have different clinical and radiological results than hook plate alone (H), and arthroscopically assisted TightRope (TR) techniques in treating acute type V AC joint dislocations.MATERIAL AND METHODS: This retrospective study included 71 patients with acute type V AC joint dislocations between December 2010 and August 2018. Patients were categorized into three groups: H group (n=22), HA group (n=23) and TR group (n=26). We measured the coracoclavicular distance (CCD) differences and CCD ratio compared to uninjured side pre-operatively, immediately post-operatively, at 3-month and 2-year after operation. Clinical outcomes were assessed as well at the same time points. Loss of correction was determined by the CCD difference and ratio between surgical and uninjured sides.RESULTS: The mean age and follow-up period were 41.8±24.7 years and 30.2±4.3 months, respectively. No significant differences were found in the demographic data between the three groups. The HA group presented a trend of less overcorrection but without significance compared with the H group at immediately post-operation, 3-month, and 2-year follow-up. (CCD difference: -2.4mm vs. -3.7mm, -1.6mm vs. -1.8, and 0.2mm vs -1.9mm, CCD ratio: 67.7% vs. 40.9%, 79.3% vs. 70.1%, and 100.6% vs. 86.5%, respectively). The HA group also had significantly less loss of correction compared with the TR group at 3-month and 2-year after the operation (CCD difference: -1.6mm vs. 1.6mm, 0.2mm vs. 2.4mm; CCD ratio: 79.3% vs. 122.2%, 100.6% vs. 136.1%, all p<0.05). All three methods achieved significant improvement in function and pain without inter-group differences. No coracoid-related or tunnel complications occurred.DISCUSSION: The hook plate alone, and hook plate with suture anchor augmentation techniques provided less residual vertical instability compared to TightRope fixation at 2-year follow-up. The patient-reported functional outcomes were promising and comparable among the three groups.LEVEL OF EVIDENCE: III, Retrospective comparative therapeutic trial.
KW - Acromioclavicular joint dislocation
KW - Arthroscopically assisted TightRope fixation
KW - Hook plate
KW - Hook plate augmented with suture anchor
KW - Joint Dislocations/diagnostic imaging
KW - Suture Anchors
KW - Acromioclavicular Joint/diagnostic imaging
KW - Humans
KW - Treatment Outcome
KW - Retrospective Studies
KW - Bone Plates
KW - Shoulder Dislocation
UR - https://www.scopus.com/pages/publications/85152949937
U2 - 10.1016/j.otsr.2022.103494
DO - 10.1016/j.otsr.2022.103494
M3 - 文章
C2 - 36455863
AN - SCOPUS:85152949937
SN - 1877-0568
VL - 109
SP - 103494
JO - Orthopaedics and Traumatology: Surgery and Research
JF - Orthopaedics and Traumatology: Surgery and Research
IS - 4
M1 - 103494
ER -