All-arthroscopic, Guideless Single Suture-button Fixation of Acute Acromioclavicular Joint Dislocation: A Description of the Technique and Early Treatment Results

Altintas,  Burak; Yildiz,  Fatih; Uzer,  Gokcer; Kapicioglu,  Mehmet; Bilsel,  Kerem

doi:2017.20.2.59

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Original Article

Clinics in Shoulder and Elbow 2017;20(2):59-67.
DOI: https://doi.org/10.5397/cise.2017.20.2.59 Published online June 30, 2017.

All-arthroscopic, Guideless Single Suture-button Fixation of Acute Acromioclavicular Joint Dislocation: A Description of the Technique and Early Treatment Results

Burak Altintas, Fatih Yildiz, Gokcer Uzer, Mehmet Kapicioglu, Kerem Bilsel

¹Sporthopaedicum Regensburg, Regensburg, Germany.
²Department of Orthopaedics and Traumatology, Bezmialem Vakif University, Istanbul, Turkey. kbilsel@gmail.com

Received: 13 February 2017 • Revised: 19 April 2017 • Accepted: 23 April 2017

Abstract

BACKGROUND: The purpose of this study was to examine the clinical and radiological results of the all-arthroscopic, suture-button fixation technique to treat acute acromioclavicular (AC) joint separations.
METHODS
All patients with acute AC joint separations received all-arthroscopic, single suture-button (TightRope) procedure without a special guide. Postoperative Constant score (CS), pain level according to visual analogue scale, and range of motion (ROM) were evaluated. For radiological evaluation, coracoclavicular distances were measured bilaterally.
RESULTS
Between December 2010 and June 2012, 18 consecutive patients (4 women and 14 men; mean age, 29.3 years) with acute AC joint separations underwent surgical treatment after 6.4 days (range, 2?20 days) following the initial trauma. The average postoperative follow-up was 16.9 months. The mean CS was 92.4 (range, 84?96). The mean external rotation, forward flexion, and abduction were 75.8° (range, 50°?90°), 170° (range, 150°?180°), and 163.8° (range, 140°?180°), respectively. Five patients exhibited coracoclavicular ossifications. In two patients, superficial wound infections were successfully treated with antibiotic therapy. In one patient, a coracoid fracture was observed. No significant differences were found regarding pain, ROM, or strength parameters between both sides. The coracoclavicular distance was discovered to be approximately 2.8 mm greater on the affected side; however, this minimal reduction loss did not affect the functional results.
CONCLUSIONS
The findings of this study suggests that all-arthroscopic treatment of AC joint separations using the single suture-button technique without a drill guide is safe, yielding good to excellent clinical results.

Key Words: Acromioclavicular joint dislocation; Arthroscopic fixation; Suture-button fixation

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