[Clinical efficacy of TightRope combined with threaded anchors in the treatment of acromioclavicular joint dislocation].

OBJECTIVE

To compare short-term and long-term efficacy of TightRope combined with threaded anchor bolts and clavicular hook plate fixation in treating acromioclavicular joint dislocation.

METHODS

A retrospective analysis was conducted on clinical data of 90 patients with acromioclavicular joint dislocation admitted from March 2020 to March 2024. They were divided into anchor group and plate group according to surgical methods. There were 48 patients in anchor group, including 30 males and 18 females, aged from 18 to 65 years old with an average of (42.35±9.21) years old;20 patients caused by traffic accident injuries, 18 patients caused by sports injuries and 10 patients caused by falling;15 patients with type Ⅲ, 20 patients with type Ⅳ, and 13 patients with type Ⅴ according to Rockwood classification;26 patients on the left side and 22 patients on the right side;the time from injury to operation ranged from 2 to 7 days with an average of (4.62±1.13) days;TightRope combined with wire anchor technology was adopted. There were 42 patients in steel plate group, including 22 males and 20 females, aged from 20 to 64 years old with an average of (41.87±8.97) years old;18 patients caused by traffic accident injuries, 15 patients caused by sports injuries and 9 patients caused by falling; 14 patients with type Ⅲ, 17 patients with type Ⅳ, and 11 patients with type Ⅴ according to Rockwood classification;22 patients on the left side and 20 patients on the right side;the time from injury to operation ranged from 3 to 7 days with an average of (4.54±1.10) days;clavicular hook plates were used for fixation. The operation time, intraoperative blood loss, hospital stay and complications between two groups were compared. The changes of shoulder joint range of motion (flexion and elevation, abduction and elevation), visual analogue scale (VAS) for pain and Constant-Murley score were compared before operation, 3 months after operation respectively. At the latest follow-up, Karlsson score was used to compare its clinical efficacy.

RESULTS

Both groups of patients were successfully completed surgery and were followed up. The follow-up time of anchor group ranged from 8 to 33 months with an average of (16.22±5.09) months, and that of plate group ranged from 9 to 37 months with an average of (16.72±6.23) months. There was no statistically significant difference between two groups (P>0.05). There was no statistically significant difference in operation time between two groups (P>0.05). The intraoperative blood loss and postoperative hospital stay in anchor group were (50.26±14.82) ml and (5.21±1.29) d respectively, which were better than those in plate group (68.90±16.18) ml and (6.28±1.52) d, and the differences were statistically significant(P<0.001). At 3 months after operation, the range of motion of forward flexion, upward lift and abduction and upward lift in anchor group were (140.25±5.63)° and (145.79±6.05)° respectively, which were greater than those in plate group (135.02±6.29) ° and (138.19±6.31)°, and the difference were statistically significant (P<0.001). VAS of anthor group was(1.22±0.52), which was lower than that of plate group(2.51±0.77);and Constant-Murley score of anchor group was(85.69±5.52) points, which was higher than that of plate group (75.32±7.12) points, and the differences were statistically significant(P<0.001). At the latest follow-up, according to Karlsson score, 42 patients were excellent, 4 good, and 2 poor in anchor group;28 patients got excellent result, 7 good and 7 poor in steel plate group;anchor group was superior to steel plate group, and the difference was statistically significant (χ2=3.889, P=0.049). In anchor group, 1 patient occurred postoperative infection and 2 patients occurred joint stiffness;2 patients occurred infection, 1 patient occurred nerve injury, 1 patient occurred internal fixation loosening and displacement, 4 patients occurred joint stiffness, and 2 patients occurred recurrent dislocation in plate group.

CONCLUSION

TightRope combined with thread anchor technique for the treatment of acromioclavicular joint dislocation could effectively relieve postoperative pain, improve shoulder joint function, reduce the occurrence of complications, and has good clinical efficacy, providing a safe and effective option for the treatment of acromioclavicular joint dislocation.