Functional and radiological outcomes following arthroscopic-assisted tight-rope technique versus clavicular hook plate fixation in management of acute acromioclavicular joint dislocation

Purpose
The purpose of this study is to assess the clinical and radiological results following using the clavicular hook plate (CHP) and the arthroscopic-assisted Tight rope (TR) technique for the treatment of acute acromioclavicular joint (ACJ) dislocation.
Patients and methods
This study included 58 patients, with acute ACJ dislocation who were equally distributed into two groups. Patients in group A were treated using the arthroscopic-assisted TR technique. Patients in group B underwent open reduction and internal fixation using the CHP. The shoulder functional results were assessed using the Constant and Murley score (CMS) at preoperative and 1-year follow-up. The radiological assessment involved the comparison of the coracoclavicular distance (CCD) at preoperative and 1-year following surgery.
Results
Patients in both groups showed a significant improvement in the CMS, visual analog scale (VAS), and CCD at 1-year follow-up compared with the preoperative values (P<0.001). The mean CMS, VAS, and CCD improved significantly in the TR group to 91.14, 2.17, and 10.52, respectively, at 1-year follow-up. In the CHP group, the mean CMS, VAS, and CCD improved significantly to 87.34, 3.14, and 10.55, respectively, 1-year after surgery. However, the TR group showed statistically significant better CMS and VAS at 1-year follow-up. No statistically significant differences were noted regarding the CCD between both groups at 1-year follow-up.
Conclusions
Successful and comparable functional and radiological outcomes are associated with using the CHP and the arthroscopic-assisted TR technique following treatment of acute ACJ dislocation. However, patients treated with the arthroscopic-assisted TR technique had significantly better CMS and VAS than those in the CHPP group at 1-year follow-up. No significant differences were observed between both groups regarding the overall rate of complications.
Level of evidence
Level II, prospective randomized comparative study.