Assessment of Coracoclavicular Ligament Healing on MRI After Arthroscopic TightRope Fixation for Acute Acromioclavicular Joint Dislocation

Abstract

Background: Arthroscopic-assisted fixation of acute high-grade acromioclavicular (AC) joint dislocation has gained popularity in the last decade. Coracoclavicular (CC) fixation using the TightRope device is a less invasive technique. Purpose: To investigate CC ligament healing and functional outcomes after arthroscopic fixation using the TightRope device for acute AC joint disruption. Study Design: Case series; Level of evidence, 4. Methods: The study retrospectively analyzed the data of patients admitted for arthroscopic surgical treatment of acute AC joint injury using a single TightRope device. The data collection commenced in October 2021. The Constant-Murley (CM) score and University of California, Los Angeles (UCLA) shoulder score were used for functional evaluation. The CC distance (CCD) was measured on plain radiographs, whereas healing of the CC ligament was evaluated on magnetic resonance imaging (MRI). Statistical analyses were conducted with the Mann-Whitney U test, independent t test, or paired t test, as appropriate. Results: The analysis included 33 patients with a mean age of 37.7 years (range, 24-49 years) and a minimum follow-up of 24 months. Significant preoperative to postoperative increases were noted in both the CM and UCLA scores (from 34.1 ± 7.6 to 93.3 ± 3.6 and from 8.7 ± 2.1 to 32.9 ± 1.7, respectively; P < .0001 for both). The CCD decreased from 21.8 ± 3.02 mm preoperatively to 10.6 ± 1.2 mm postoperatively ( P < .0001). All patients displayed CC ligament healing on MRI. Two patients with superficial infection and 1 case of partial reduction loss were confirmed at the end of this study. Conclusion: The arthroscopic TightRope technique was found to be a reliable and less invasive method of fixation for acute AC joint disruptions. The CC ligament healed adequately based on MRI evaluation, and the patients regained their preinjury activities, with favorable functional outcomes and minor comorbidities.

The Effect of Clavicular Tunnel Position on Reduction Loss in Patients with Acute Acromioclavicular Joint Dislocations Operated with a Single‐Bundle Suspensory Loop Device

“…Developments in implant technologies lead orthopaedic interventions to be more minimally invasive and biological. With adjustable SLDs, it is aimed to maintain joint reduction until the CC ligaments heal by supporting the stabilization of the ACJ in the vertical direction 15 . Compared to hook plate, SLD has been reported to exhibit lower complications and higher clinical scores due to its minimally invasive method 16 .…”

“…With adjustable SLDs, it is aimed to maintain joint reduction until the CC ligaments heal by supporting the stabilization of the ACJ in the vertical direction. 15 Compared to hook plate, SLD has been reported to exhibit lower complications and higher clinical scores due to its minimally invasive method. 16 Additionally, it was emphasized that similarly excellent results were obtained with suture anchor and SLD, and there was no difference in terms of ACJ stability.…”