Arthroscopic acromio-clavicular joint stabilization using a TightRope device

Abstract

Purpose/objectivesThe purpose of the present study was to evaluate the outcome of arthroscopic stabilization of acute acromio-clavicular joint dislocation using a TightRope device. Material and methodsBetween june 2015 to march 2017, 12 patients (9 males and 3 females), aged 39.5 (23–64) years underwent arthroscopic stabilization using a double-button device for acute (2–4 days) acromio-clavicular joint injury, which included acromio-clavicular joint dislocation Rockwood Type III (n = 4), Type IV (n = 5) and Type V (n = 3). Data was collected retrospectively, and clinical assessment on follow-up included the Shoulder Constant Score and Visual Analogue Scale (VAS) for residual pain. Time of return to work was assessed and post-operative complications were recorded. Radiological examination consisted of antero-posterior (Zanca) view of the shoulder, and coraco-clavicular distance before and after surgery. ResultsThe mean follow-up period was 28.75 (12–38) months, where the Constant Score at final follow-up was 90.4 ± 3.06 and Visual Analogue Scale score was 0.58 (0–1) on activity. The coraco-clavicular distance decreased from 20.18 ± 2.84 mm pre-operatively to 10.02 ± 0.39 mmat 6 months and 10.68 ± 0.55 mmat 1 year post-operatively. There were no failures. X-rays did not show acromio-clavicular joint arthritis or lysis around the endo-button. There was no tenderness and no evidence of vertical or horizontal instability at the acromio-clavicular joint, but 4 patients had tenderness at the endo-button insertion site. All the patients returned to work after an average of 2.6 (2–4) months. ConclusionArthroscopic stabilization of acute acromio-clavicular joint dislocation using a TightRope device is a minimally invasive procedure with decreased post-operative morbidity. It allows early rehabilitation and consistently provides a satisfactory outcome when performed in the acute phase of injury.