Early clinical efficacy of arthroscopic Twin Tail TightRope Y-shaped fixation in the treatment of acromioclavicular joint dislocation of Rockwood typeIIIb or more

Abstract

Background Acromioclavicular joint dislocation is mainly caused by direct violence, and its pathological basis is mainly the injuries of acromioclavicular joint capsule, coracoclavicular ligament and acromioclavicularligament in different levels, which causes acromioclavicular joint to be unstable. The acromioclavicular joint dislocation is one of the common injuries in shoulder, and its incidence rate accounts for 4.40% -5.89% of the systematic fracture and dislocation and 12% of the shoulder joint injury. Currently, the consensus has beenreached that Rockwood types I, II and IIIa acromioclavicular joint dislocation can achieve satisfactory result with conservative treatment,whilethesurgical treatment is indicated for the acromioclavicular joint dislocationof Rockwood type IIIb or above . Traditional clavicular hook plate for the treatment of acromioclavicular joint dislocation has many complications. On the other hand, the arthroscopic minimally invasive reconstruction of acromioclavicular joint stability becomes the preferred choice for orthopedic surgeon. Twin Tail TightRope Y-shaped fixation is a new generation of treatment method. Meanwhile, it satisfies the rigid anatomical reduction of acromioclavicular joint, allowing the postoperative micromotion of acromioclavicular joint with small incision,early functional rehabilitation and no need for the removal of internal fixator. Objective To evaluate the early clinical efficacy of Twin Tail TightRope Y-shaped fixation in the treatment of acute acromioclavicular dislocation. Methods From June 2015 to June 2017, a total of 16 patients with acute acromioclavicular dislocation were treated with arthroscopic Twin Tail TightRope Y-shaped fixation, and the data was retrospectively analyzed. The VAS, and Constant-Murley scoring systems were used to evaluate the surgical effect. Results All patients were followed up for 3-12 months with an average of (6.48±1.51) months. No neurovascular injury or incision infection occurred. During the last follow up, no reduction loss, clavicular stress fracture, coracoid process cutting or other complication occurred. During the last follow up: the postoperative VAS score (0.36±0.04) was lower than the preoperative score (7.46±1.24) ; the postoperative Constant-Murley score (90.07±3.13) was higher than the preoperative score (46.13±3.25) . Conclusion The Twin Tail TightRope Y-shaped fixation for the treatment of acute acromioclavicular dislocation can effectively solve the problems of postoperative horizontal and anteroposterior instabilities.This technique has relatively low incidences of clavicle and coracoid process fractures, and the arthroscopic operation can reduce surgical injury and improve accuracy. Key words: Acromioclavicular joint dislocation; Twin Tail TightRope; Y-shapedfixation; Arthroscopy