1 宜兴市人民医院骨科，江苏 宜兴 214200
Comparison of TightRope system and hook plate fixation with coracoacromial ligament transfer in the treatment of Rockwood type III acromioclavicular joint dislocation
CorrespondingAuthor: ZHOU Jiangang Email: firstname.lastname@example.org
Foundation: This work was supported by the 2021 Clinical Medical Science and Technology Development Fund Project of Jiangsu University, China (JLY2021039).
Objective: The aim of this study was to evaluate the short-term efficacy of TightRope system versus hook plate fixation with coracoacromial ligament transfer in the treatment of Rockwood type III acromioclavicular joint dislocation. Methods: From January 2015 to December 2019, 60 cases in Yixing People’s Hospital with Rockwood type III acromioclavicular joint dislocation were retrospectively evaluated. The 60 cases, with an average age of 42.4 years (21 to 60 years), were divided into the TightRope group (n=30) and the Hook plate ligament transfer group (n=30) according to different treatment technique. The length of incision, procedure time, intraoperative blood loss, Visual Analog Scale (VAS) score, the Constant-Murley Shoulder Joint Function (CS) score, postoperative acromioclavicular recovery, and complications were compared between the 2 groups. The postoperative Karlsson efficacy score of the acromioclavicular joint was recorded. Results: The results showed that patients in the TightRope group had longer procedure time [(57.30±5.27) min vs (63.30±5.49) min], longer skin length [(7.40±0.86) cm vs (10.13±1.07) cm], less estimated blood loss [(49.33±6.91) mL vs (64.5±9.83) mL], and there were significant differences (all P<0.001). CS score at 3 months follow-up [(91.07±3.69) vs (87.30±7.19)] of the TightRope group was higher than that of the Hook plate ligament transfer group, and the difference was statistically significant (P<0.05). VAS score at 6 months follow-up of the TightRope group was lower than that of the Hook plate ligament transfer group [(0.73±0.45) vs (1.43±0.82), P<0.001]. The excellent rates of Karlsson score were 100% (30/30) and 96.7% (29/30), respectively, and the difference was not statistically significant (P>0.05). Conclusion: The treatment of Rockwood type III acromioclavicular joint dislocation by TightRope system or hook plate fixation with coracoacromial ligament transfer can obtain satisfactory short-term efficacy. However, the TightRope system exhibited obvious advantages in terms of incision length, procedure time, blood loss and no need for a second surgery. Patients received the TightRope system could have more range of motion and muscle strength at 3 months follow-up, less pain at 6 months follow-up.