The long-term efficacy of the GraftRope technique

Abstract

Acromioclavicular joint separations continue to be a challenge for surgeons, and modern arthroscopically assisted techniques are becoming increasingly widespread. The aim of this study is to evaluate if the use of a biological support in association with a nonresorbable subcoracoid fixation can improve long-term stability in acromioclavicular joint dislocation surgically treated. We assessed clinical and radiographicresults, patients' return to daily activities and the risk of complications. Fourteen patients underwent subcoracoid fixation with the GraftRope system for chronic Rockwood type IV acromioclavicular joint dislocation. A total of 12 patients were evaluated clinically and radiologically with a minimum of 7 years of follow-up. Good reduction was obtained in all patients. All patients returned to work and sports at the pretrauma level with high mean scores on clinical evaluation. Regarding complications, 3 patients developed acromioclavicular arthritis. Ossifications were a common finding on x-rays, but they did not worsen the clinical outcome. The GraftRope surgical technique allows us to obtain an anatomical reduction of the acromio-clavicular joint, along with the restoration of the mechanical properties of the joint, owing to the use of a biological material with rigidity and load resistance features. Clinical results over the long term are encouraging. However, a 6-mm bone tunnel is too large since the average thickness of the coracoid process is only approximately 12 mm. This technique has some advantages over others: it avoids detachment of the deltoid, avoids the use of bulky metal implants with an important dissection of soft tissue, while it has all the advantages of an arthroscopic procedure.