Single tunnel technique versus coracoid sling technique for arthroscopic treatment of acute acromioclavicular joint dislocation

Liangquan Peng,Greg Zhang,Chao Cheng,Yizi Zheng,Siyu Chen,Junjie Liu,Zhenhan Deng,Shiwei Yang

doi:10.1038/s41598-022-07644-z

Abstract

To evaluate and compare the efficacy of two techniques for the treatment of acute acromioclavicular joint dislocation, the charts of 60 patients diagnosed with acute Rockwood type IV and V acromioclavicular joint dislocation that undergone arthroscopic fixation procedure with single tunnel technique (N = 30, 30.7 ± 5.7 years old) or coracoid sling technique (N = 30, 30.1 ± 5.4 years old) fixation were retrospectively reviewed. The Visual Analog Scale pain score, Constant shoulder functionality score, Karlsson acromioclavicular joint score, the time of return to sports and activity, and plain radiographs of the affected shoulder at different time points of follow-up were recorded for a minimum of 2 years post-op. The majority of the patients recovered to their preoperative activity levels with few complications. The average postoperative acromioclavicular and coracoclavicular distances were significantly narrower than preoperative measurements in both groups without significant difference between the two groups at 2 years post-op (P < 0.05). The coracoid sling technique group had reduced operative time, shorter time of recovery of shoulder movements, higher Constant functionality scores and Karlsson acromioclavicular joint scores, and fewer complications than the single tunnel technique group at the last follow-up (P < 0.05). Therefore, coracoid sling technique achieved superior clinical outcomes with fewer complications compared to the traditional single tunnel technique in arthroscopic treatment of acute acromioclavicular joint dislocation.

Highlights

To evaluate and compare the efficacy of two techniques for the treatment of acute acromioclavicular joint dislocation, the charts of 60 patients diagnosed with acute Rockwood type IV and V acromioclavicular joint dislocation that undergone arthroscopic fixation procedure with single tunnel technique (N = 30, 30.7 ± 5.7 years old) or coracoid sling technique (N = 30, 30.1 ± 5.4 years old) fixation were retrospectively reviewed
It is generally agreed that type I-II injuries are caused by low-energy trauma and should be treated conservatively using a sling or harness, whereas type IV-VI dislocations are caused by high-energy trauma and require surgical treatment
These various options range from rigid fixation with Kirschner wires, tension bands, or hook plates, to the Weaver-Dunn procedure, which is a ligament reconstruction procedure based on the transference of AC ligament[6]

Summary

Introduction

The coracoid sling technique group had reduced operative time, shorter time of recovery of shoulder movements, higher Constant functionality scores and Karlsson acromioclavicular joint scores, and fewer complications than the single tunnel technique group at the last follow-up (P < 0.05). Coracoid sling technique achieved superior clinical outcomes with fewer complications compared to the traditional single tunnel technique in arthroscopic treatment of acute acromioclavicular joint dislocation. Previous works have reported good curative effects by using the arthroscopic TightRope system or paired Endobutton Technique (PET) for surgical treatment of acute AC joint dislocation. Among these methods, the single tunnel technique (STT) using the TightRope system or PET is the most widely utilized[8,9]. It has been accentuated that transclavicular-transcoracoid drilling should be approached with caution[15]

Methods

Results

Conclusion