Arthroscopic stabilization of acute acromioclavicular joint dislocation with tightrope AC system: A tale of failures

BackgroundStabilization of acromioclavicular joint is a challenging technique with several methods described in literature from non-biological methods to biological fixation of AC joint. Arthroscopic fixation of AC joint is a newer technique with limited literature available. The aim of our study is to evaluate the results of arthroscopic stabilization of acute acromioclavicular joint with tightrope.MethodsFrom February 2013 till August 2013, arthroscopic stabilization of acute ACJ dislocation was performed in 11 patients. The group consisted of eight men and three women with an average age of 34.2 years. The Rockwood type III to type V ACJ dislocations (III, 6; IV, 2; V, 3) were indicated for surgery. The average interval between injury and surgery was 5.4 days. In all cases, a second-generation tightrope implant was inserted by the Endobutton technique joining the distal end of the clavicle and the coracoid process. The results were evaluated using the UCLA Shoulder Scale at 10 months after surgery.ResultsAll 11 patients returned to their preoperative activities without any restriction of shoulder motion within 5 months of surgery. The average postoperative UCLA score was 30.3 points (range 27–34). Radiographic evidence of the loss of partial reduction, with no effect on the clinical outcome, was recorded in 5 patients (45%) and loss of full reduction noted in 5 (45%) patients during postoperative rehabilitation. One patient was lost in follow-up.ConclusionArthroscopic stabilization of acute ACJ dislocations using a single tightrope implant is a minimally invasive surgical technique, but less satisfactory result may be because of non-biological nature of fixation. Non-biological AC joint fixation is not a good method of fixation of a biological AC joint.