Comparison of trans-articular Kirschner wire fixation and TightRope System for the treatment of acromioclavicular joint injuries

Yıl 2021, Cilt: 4 Sayı: 5, 650 - 655, 05.09.2021

Seçkin Basılgan , Gökay Eken

https://doi.org/10.32322/jhsm.948045

Öz

Aim: Acromioclavicular joint (ACJ) injuries are common among the young and middle-aged population. The management of Grade III ACJ injuries is still controversial. The purpose of the present study was to compare the clinical results and complication rates of trans-articular Kirschner (K) wire fixation and the TightRope System for surgically treated ACJ injuries.
Material and Method: Patients with Grade III or more ACJ injuries surgically treated for acute ACJ injuries were included in the study. The patients were grouped according to the fixation method; the patients treated with the TightRope System were called Group 1 (n=17). The patients treated with trans-articular K-wire fixation were called Group 2 (n=21). The American Shoulder and Elbow Surgeons (ASES), Constant-Murley (CS), Visual Analog Scale (VAS) scores, and shoulder range of motion (ROM) values were evaluated, and the complications were recorded and compared between the two groups.
Results: Thirty-eight patients (7 females, 31 males) were included in the study with a mean age of 33±9.04. There was no significant difference between the two groups in terms of demographic and preoperative variables. ASES (P=0.400), CS (P=0.172), VAS (P=0.234), and ROM values were similar between the two groups. The rate of complications was significantly higher in Group 2 (P=0.025).
Conclusion: Trans-articular K-wire fixation and the TightRope System have similar clinical scores and ROM values; on the other hand, trans-articular K-wire fixation has significantly higher complication rates.

Anahtar Kelimeler

acromioclavicular joint, injury, surgical treatment

Kaynakça

• Mazzocca AD, Arciero RA, Bicos J. Evaluation and treatment of acromioclavicular joint injuries. Am J Sports Med. 2007; 35: 316-29.
• Lafosse L, Baier GP, Leuzinger J. Arthroscopic treatment of acute and chronic acromioclavicular joint dislocation. Arthroscopy. 2005; 21: 1017.
• Alyas F, Curtis M, Speed C, Saifuddin A, Connell D. MR imaging appearances of acromioclavicular joint dislocation. Radiographics. 2008; 28: 463-79.
• Modi CS, Beazley J, Zywiel MG, Lawrence TM, Veillette CJ. Controversies relating to the management of acromioclavicular joint dislocations. Bone Joint J. 2013; 95: 1595-602.
• Beitzel K, Cote MP, Apostolakos J, Solovyova O, Judson CH, Ziegler CG, et al. Current concepts in the treatment of acromioclavicular joint dislocations. Arthroscopy. 2013; 29: 387-97.
• Gorbaty JD, Hsu JE, Gee AO. Classifications in Brief: Rockwood Classification of Acromioclavicular Joint Separations. Clin Orthop Relat Res. 2017; 475: 283-7.
• Johansen JA, Grutter PW, McFarland EG, Petersen SA. Acromioclavicular joint injuries: indications for treatment and treatment options. J Shoulder Elbow Surg. 2011; 20: 70-82.
• Pavlik A, Csépai D, Hidas P. Surgical treatment of chronic acromioclavicular joint dislocation by modified Weaver-Dunn procedure. Knee Surg Sports Traumatol Art. 2001; 9: 307–12.
• Wylie JD, Beckmann JT, Granger E, Tashjian RZ. Functional outcomes assessment in shoulder surgery. World J Orthop. 2014; 5: 623-33.
• Leidel BA, Braunstein V, Kirchhoff C, Pilotto S, Mutschler W, Biberthaler P. Consistency of long-term outcome of acute Rockwood grade III acromioclavicular joint separations after K-wire transfixation. J Trauma. 2009; 66: 1666-71.
• Sirveaux F, Traversari R, Roche O, Mole D. Outcome more than ten years after surgical treatment of acromioclavicular disjunction. J Bone Joint Surg Br. 2001; 83: 36.
• Murphy M, Connolly P, Murphy P, McElwain JP. Retrospective review of outcome post open reduction and K-wire fixation for grade III acromioclavicular joint subluxations. Eur J Orthop Surg Traumatol. 2004; 14: 147-50.
• Vrgoč G, Japjec M, Jurina P, Gulan G, Janković S, Šebečić B, et al. Operative treatment of acute acromioclavicular dislocations Rockwood III and V-Comparative study between K-wires combined with FiberTape(®) vs. TightRope System(®). Injury. 2015; 46: 107-12.
• Virtanen KJ, Remes VM, Tulikoura IT, Pajarinen JT, Savolainen VT, Björkenheim JM, et al. Surgical treatment of Rockwood grade-V acromioclavicular joint dislocations: 50 patients followed for 15–22 years. Acta Orthop. 2013; 84:191-5.
• Horst K, Garving C, Thometzki T, Lichte P, Knobe M, Dienstknecht T, et al. Comparative study on the treatment of Rockwood type III acute acromioclavicular dislocation: Clinical results from the TightRope® technique vs. K-wire fixation. Orthop Traumatol Surg Res. 2017; 103: 171-6.
• Fialka C, Michlits W, Stampfl P, Oberleitner G, Funovic P, Schmidt W, et al. Biomechanical analysis of different operative techniques for complete acromioclavicular joint disruptions. Osteosynthesis and Trauma Care. 2005; 13: 154-9.
• Cai L, Wang T, Lu D, Hu W, Hong J, Chen H. Comparison of the Tight Rope Technique and Clavicular Hook Plate for the Treatment of Rockwood Type III Acromioclavicular Joint Dislocation. J Invest Surg. 2018; 31: 226-33.
• Walz L, Salzmann GM, -Fabbro T, Eichhorn S, Imhoff AB. The anatomic reconstruction of acromioclavicular joint dislocations using 2 TightRope devices: a biomechanical study. Am J Sports Med. 2008; 36: 2398–406.
• Nuchtern JV, Sellenschloh K, Bishop N, Jauch S, Briem D, Hoffmann M, et al. Biomechanical evaluation of 3 stabilization methods on acromioclavicular joint dislocations. Am J Sports Med. 2013; 41: 1387-94.
• Zooker CC, Parks BG, White KL, Hinton RY. TightRope versus fiber mesh tape augmentation of acromioclavicular joint reconstruction: a biomechanical study. Am J Sports Med. 2010; 38: 1204-8.
• Ladermann A, Gueorguiev B, Stimec B, Fasel J, Rothstock S, Hoffmeyer P. Acromioclavicular joint reconstruction: a comparative biomechanical study of three techniques. J Shoulder Elbow Surg. 2013; 22: 171-8.
• Thiel E, Mutnal A, Gilot GJ. Surgical outcome following arthroscopic fixation of acromioclavicular joint disruption with the tightrope device. Orthopedics. 2011; 34: 267-74.
• Beris A, Lykissas M, Kostas-Agnantis I, Vekris M, Mitsionis G, Korompilias A. Management of acute acromioclavicular joint dislocation with a double-button fixation system. Injury. 2013; 44: 288-92.
• Fraser-Moodie JA, Shortt NL, Robinson CM. Injuries to the acromioclavicular joint. J Bone Joint Surg Br. 2008; 90: 697-707.
• Hackenburch W, Regazzoni P, Schwyzer K. Surgical treatment of lateral clavicular fracture with the clavicular hooked plate. Z. Unfallchir. Versicherungsmed. 1994; 87: 145-52.
• Motta P, Maderni A, Bruno L, Mariotti U. Suture rupture in acromioclavicular joint dislocations treated with flip buttons. Arthroscopy. 2011; 27: 294-8.
• Scheibel M, Droschel S, Gerhardt C, Kraus N. Arthroscopically assisted stabilization of acute high-grade acromioclavicular joint separations. Am J Sports Med. 2011; 39: 1507–16.
• Defoort S, Verborgt O. Functional and radiological outcome after arthroscopic and open acromioclavicular stabilization using a doublebutton fixation system. Acta Orthop Belg. 2010; 76: 585–91.