Elhalawany Mohamed Fathy, Abdalla Usama Gaber, Shwitter Lotfy, ElAttar Mohammed Said, Fahmy Fahmy Samir
Department of Orthopedic Surgery, Faculty of Medicine, AlAzhar University, Cairo, Egypt.
Department of Orthopedic Surgery, Faculty of Medicine, Zagazig University, Sharkia, Egypt.
Orthop J Sports Med. 2023 Oct 11;11(10):23259671231185749. doi: 10.1177/23259671231185749. eCollection 2023 Oct.
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.
To investigate CC ligament healing and functional outcomes after arthroscopic fixation using the TightRope device for acute AC joint disruption.
Case series; Level of evidence, 4.
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 test, independent test, or paired test, as appropriate.
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; < .0001 for both). The CCD decreased from 21.8 ± 3.02 mm preoperatively to 10.6 ± 1.2 mm postoperatively ( < .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.
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.
在过去十年中，关节镜辅助下固定急性重度肩锁关节（AC）脱位越来越受到欢迎。使用TightRope装置进行喙锁（CC）固定是一种侵入性较小的技术。
探讨使用TightRope装置进行关节镜固定急性AC关节脱位后CC韧带的愈合情况及功能结果。
病例系列；证据等级，4级。
本研究回顾性分析了使用单个TightRope装置对急性AC关节损伤进行关节镜手术治疗的患者数据。数据收集于2021年10月开始。采用Constant-Murley（CM）评分和加利福尼亚大学洛杉矶分校（UCLA）肩部评分进行功能评估。在X线平片上测量CC间距（CCD），而在磁共振成像（MRI）上评估CC韧带的愈合情况。根据情况分别采用Mann-Whitney检验、独立检验或配对检验进行统计分析。
分析纳入33例患者，平均年龄37.7岁（范围24-49岁），最短随访24个月。CM和UCLA评分术前至术后均有显著增加（分别从34.1±7.6增至93.3±3.6，从8.7±2.1增至32.9±1.7；两者均P<0.0001）。CCD从术前的21.8±3.02mm降至术后的10.6±1.2mm（P<0.0001）。所有患者在MRI上均显示CC韧带愈合。本研究结束时确认有2例浅表感染患者和1例部分复位丢失病例。
关节镜下TightRope技术是一种可靠且侵入性较小的急性AC关节脱位固定方法。根据MRI评估，CC韧带愈合良好，患者恢复了伤前活动，功能结果良好，并发症较少。
