Has the arthroscopically assisted reduction of acute AC joint separations with the double tight-rope technique advantages over the clavicular hook ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2012-11-04

AUTHORS

Gunnar Jensen, Jan Christoph Katthagen, Laura Esther Alvarado, Helmut Lill, Christine Voigt

ABSTRACT

PurposeThe purpose of this study was to compare the results after arthroscopically assisted double TightRope®—(TR) reduction with results after clavicular hook plate (HP) fixation in acute high-grade acromioclavicular (AC) joint separations.MethodsBetween 2004 and 2010, 69 consecutive patients with acute AC joint separations type Rockwood III and V were subjected to surgical reconstruction. 56 patients (81 %) were available for evaluation. Thereof, 30 (median age: 39 years; n = 12 acute Rockwood III and n = 18 Rockwood V injuries) were treated by a clavicular HP and 26 (median age: 39 years; n = 10 acute Rockwood III and n = 16 Rockwood V injuries) using the double TR technique. Group HP was evaluated at a median of 48 (7–77) months after surgery and the TR group 17 (7–29) months after stabilization. Visual Analogue Scale (VAS) for Pain, Simple Shoulder Test (SST), Constant Score (CS) and Taft Score (TS) were assessed. Sonographic measurements were performed to evaluate recurrent instability.ResultsClinical examination demonstrated comparable results without significant differences. In the groups HP and TR, the VAS was median 0.8 (range, 0.0–7.5) and 0.4 (range, 0.0–5.7), the SST reached median 11 (range, 0–12 points) and 12 points (range, 8–12 points). The CS was median 92.4 % (range, 21.5–105.4 %) and 94.0 % (range, 54.6–105.3 %) and the TS median 10 (range, 3–12 points) and 10 points (range, 5–12 points). Sonographic measurements showed a mean coracoclavicular (CC) distance of 25.3 ± 4.5 (HP) and 25.5 ± 4.3 mm (TR) (n.s.). In both groups, CC distance of the operated side was significantly higher compared to the uninjured side. The complication rate was 13 % in group HP and 12 % in group TR.ConclusionsIn acute high-grade AC joint instabilities, both techniques lead to mostly good and excellent clinical results, although comparable partial recurrent vertical instability could be observed. Diagnosis and therapy of concomitant glenohumeral injuries and no obligatory implant removal are advantages of the arthroscopic procedure.Level of evidenceTherapeutic; retrospective comparative study, Level III. More... »

PAGES

422-430

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00167-012-2270-5

DOI

http://dx.doi.org/10.1007/s00167-012-2270-5

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1052985381

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/23124627


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33 schema:description PurposeThe purpose of this study was to compare the results after arthroscopically assisted double TightRope®—(TR) reduction with results after clavicular hook plate (HP) fixation in acute high-grade acromioclavicular (AC) joint separations.MethodsBetween 2004 and 2010, 69 consecutive patients with acute AC joint separations type Rockwood III and V were subjected to surgical reconstruction. 56 patients (81 %) were available for evaluation. Thereof, 30 (median age: 39 years; n = 12 acute Rockwood III and n = 18 Rockwood V injuries) were treated by a clavicular HP and 26 (median age: 39 years; n = 10 acute Rockwood III and n = 16 Rockwood V injuries) using the double TR technique. Group HP was evaluated at a median of 48 (7–77) months after surgery and the TR group 17 (7–29) months after stabilization. Visual Analogue Scale (VAS) for Pain, Simple Shoulder Test (SST), Constant Score (CS) and Taft Score (TS) were assessed. Sonographic measurements were performed to evaluate recurrent instability.ResultsClinical examination demonstrated comparable results without significant differences. In the groups HP and TR, the VAS was median 0.8 (range, 0.0–7.5) and 0.4 (range, 0.0–5.7), the SST reached median 11 (range, 0–12 points) and 12 points (range, 8–12 points). The CS was median 92.4 % (range, 21.5–105.4 %) and 94.0 % (range, 54.6–105.3 %) and the TS median 10 (range, 3–12 points) and 10 points (range, 5–12 points). Sonographic measurements showed a mean coracoclavicular (CC) distance of 25.3 ± 4.5 (HP) and 25.5 ± 4.3 mm (TR) (n.s.). In both groups, CC distance of the operated side was significantly higher compared to the uninjured side. The complication rate was 13 % in group HP and 12 % in group TR.ConclusionsIn acute high-grade AC joint instabilities, both techniques lead to mostly good and excellent clinical results, although comparable partial recurrent vertical instability could be observed. Diagnosis and therapy of concomitant glenohumeral injuries and no obligatory implant removal are advantages of the arthroscopic procedure.Level of evidenceTherapeutic; retrospective comparative study, Level III.
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40 schema:keywords AC joint instability
41 AC joint separations
42 AC joint separations type Rockwood III
43 CC distance
44 ConclusionsIn acute high-grade AC joint instabilities
45 Constant score
46 HP
47 MethodsBetween 2004
48 PurposeThe purpose
49 ResultsClinical examination
50 Rockwood III
51 Shoulder Test
52 Simple Shoulder Test
53 TR group 17 (7–29) months
54 TR technique
55 TS median 10
56 Taft score
57 acromioclavicular joint separation
58 acute AC joint separations
59 acute AC joint separations type Rockwood III
60 acute high-grade AC joint instabilities
61 acute high-grade acromioclavicular joint separations
62 advantages
63 analog scale
64 arthroscopic procedures
65 assisted reduction
66 clavicular HP
67 clavicular hook plate fixation
68 clinical results
69 comparable partial recurrent vertical instability
70 comparable results
71 comparative study
72 complication rate
73 concomitant glenohumeral injuries
74 consecutive patients
75 coracoclavicular distance
76 diagnosis
77 differences
78 distance
79 double TR technique
80 double TightRope
81 double tight-rope technique advantages
82 evaluation
83 examination
84 excellent clinical results
85 fixation
86 glenohumeral injuries
87 group
88 group 17 (7–29) months
89 group HP
90 group TR
91 high-grade AC joint instabilities
92 high-grade acromioclavicular joint separations
93 hook plate fixation
94 implant removal
95 injury
96 instability
97 joint instability
98 joint separation
99 joint separations type Rockwood III
100 level III
101 levels
102 mean coracoclavicular distance
103 measurements
104 median
105 median 10
106 median 11
107 months
108 obligatory implant removal
109 operated side
110 pain
111 partial recurrent vertical instability
112 patients
113 plate fixation
114 point
115 procedure
116 purpose
117 rate
118 reconstruction
119 recurrent instability
120 recurrent vertical instability
121 reduction
122 removal
123 results
124 retrospective comparative study
125 scale
126 scores
127 separation
128 separations type Rockwood III
129 side
130 significant differences
131 sonographic measurements
132 stabilization
133 study
134 surgery
135 surgical reconstruction
136 technique
137 technique's advantages
138 test
139 therapy
140 tight-rope technique advantages
141 tightrope
142 type Rockwood III
143 uninjured side
144 vertical instability
145 visual analog scale
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