Coronal plane radiographic evaluation of the single TightRope technique in the treatment of acute acromioclavicular joint injury

• Published in: Journal of shoulder and elbow surgery 2015-10, Vol.24 (10), p.1582-1587
• Main Authors: Yi, Young, MD, Kim, Jeong Woo, MD, PhD
• Format: Article
• Language: English
• Subjects: AC joint injury; Acromioclavicular Joint - diagnostic imaging; Acromioclavicular Joint - injuries; Acromioclavicular Joint - surgery; Clavicle - diagnostic imaging; Clavicle - surgery; Female; Follow-Up Studies; Humans; ight-loop; Joint Dislocations - diagnostic imaging; Joint Dislocations - surgery; Male; Orthopedic Procedures - methods; Orthopedics; Radiography; Scapula - diagnostic imaging; Scapula - surgery; Treatment Outcome; unnel placement
• ISSN: 1058-2746; 1532-6500
• DOI: 10.1016/j.jse.2015.02.022

Background This study aimed to demonstrate the technical aspects of the single TightRope (Arthrex, Naples, FL, USA) procedure for acute acromioclavicular-coracoclavicular joint dislocation, identify the predictive factors influencing its outcome, and assess and validate the significance of specific radiologic parameters. Methods We reviewed true anteroposterior shoulder radiographs of 62 consecutive patients who had undergone surgical reconstruction using TightRope for an acute acromioclavicular-coracoclavicular injury. All patients were followed up for at least 12 months between October 2009 and March 2012 and were divided into dissociated or nondissociated groups according to their surgical outcome. We measured the clavicle tunnel anteroposterior angle, distal clavicular tunnel placement, and tunnel-to-medial coracoid ratio, and compared the parameters in each group after a satisfactory intraclass correlation coefficient reliability test result. Results The angles of patients in the dissociated group were more acute compared with the angles of those in the nondissociated group, which were perpendicular, as verified statistically using the paired t test. The difference in the distal clavicular tunnel placement and tunnel-to-medial coracoid ratio between the groups was not significant. Therefore, tunnel placement is not influenced by coracoclavicular dissociation. Conclusions The clavicle tunnel anteroposterior angle can be used as a predictor of surgical outcome in coracoclavicular augmentation surgery. The surgeon should strive to place a perpendicular hole from the clavicle to the coracoid process for the TightRope fixation to enable a successful reconstruction of the acute acromioclavicular-coracoclavicular injury.