A comparison between two double-button endoscopically assisted surgical techniques for the treatment acute acromioclavicular dislocations
- 188 Downloads
To compare clinical and radiological outcomes between two endoscopically assisted double-button techniques in high-grade acute acromioclavicular separations.
A retrospective single-center study was conducted in patients with acute acromioclavicular joint dislocation Rockwood types III and V, from 2009 to 2014. All were treated endoscopically, with a 1-year minimum follow-up. Two consecutive series were conducted; the first (TR group) received the TightRope® system, whereas last series (DB group) was treated with the Dog Bone® button technology (Arthrex, Naples, FL, USA). Primary endpoints were last follow-up values of Constant score (CS) and Quick-DASH (QD) score. Moreover, the posttraumatic displacement and its evolution were assessed on bilateral Zanca radiographs. A displacement of 5 mm or greater the day after surgery was considered as a lack of reduction; the same difference on last follow-up X-rays was considered as a loss of reduction.
Forty patients were reviewed: 22 in the TR group and 18 in the DB group. After a mean follow-up of 27.7 ± 8.3 months, CS and QD averaged, respectively, 94.3 ± 4.4 and 2.0 ± 2.6 in the TR series, whereas they averaged, respectively, 95 ± 6.1 and 3.4 ± 3.3 in the DB series after a mean follow-up of 24.1 ± 5 months (PCS = 0.16, PQDS = 0.08). Lack of reduction and loss of reduction rates were significantly higher in the DB group, with P = 0.0005 and P < 0.0001, respectively.
Both techniques provided good to excellent functional outcomes. However, considering inferior radiological results using the Dog Bone® device, we would prefer the TightRope® device in acute acromioclavicular dislocations.
Level of evidence
IV: Therapeutic study—cases series.
KeywordsAcromioclavicular instability Arthroscopic stabilization Button TightRope Dog Bone
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interests. None of them has a financial interest in any of the products, devices or drugs mentioned in this manuscript. They have not received or will receive any financial aid, in any form, for this study, from any of the following organizations: National Institutes of Health (NIH); Wellcome Trust; Howard Hughes Medical Institute (HHMI); or other(s).
- 2.Rockwood CA (1984) Injuries to the acromioclavicular joint. In: Rockwood CA, Green DP (eds) Fractures in adults, vol 1, 2nd edn. JB Lippincott, Philadelphia, pp 860–910Google Scholar
- 12.Horst K, Garving C, Thometzki T et al (2016) Comparative study on the treatment of Rockwood type III acute acromioclavicular dislocation: clinical results from the TightRope® technique vs. K-wire fixation. Orthop Traumatol Surg Res pii:S1877-0568(16)30229-8Google Scholar
- 20.Arthrex Incorporation. TightRope® technique [Arthrex Inc. web site]. https://www.arthrex.com/shoulder/ac-tightrope-technique. Accessed 1 Jan 2017
- 21.Arthrex Incorporation. Dog Bone® Button [Arthrex Inc. web site]. https://www.arthrex.com/shoulder/dog-bone-button. Accessed 1 Jan 2017
- 23.Kraus N, Haas NP, Scheibel M, Gerhardt C (2013) Arthroscopically assisted stabilization of acute high-grade acromioclavicular joint separations in a coracoclavicular Double-TightRope technique: V-shaped versus parallel drill hole orientation. Arch Orthop Trauma Surg 133:1431–1440CrossRefPubMedGoogle Scholar
- 28.Brady P. The Dog Bone Technique for AC joint reconstruction. [Arthrex Inc. web site]. https://www.arthrex.com/resources/presentation/30it8OU_y0WLIgFXviksA/the-dog-bone-technique-for-ac-joint-reconstruction. Accessed 1 Jan 2017