Complications After Arthroscopic Coracoclavicular Reconstruction Using a Single Adjustable-Loop-Length Suspensory Fixation Device in Acute Acromioclavicular Joint Dislocation

摘要

Purpose: The purpose of this study was to evaluate clinical and radiological outcomes after arthroscopically assisted coracoclavicular (CC) fixation using a single adjustableeloop-length suspensory fixation device for acute acromioclavicular dislocation and to report intraoperative and postoperative complications. Methods: Eighteen consecutive patients with acute acromioclavicular dislocation underwent arthroscopically assisted CC fixation using a single TightRope (Arthrex, Naples, FL). Using the Rockwood classification, 3 patients had grade III dislocations, one patient had a grade IV dislocation, and 14 patients had grade V dislocations. Results: The preoperative CC distance of the injured shoulder was 16.1 +/- 2.7 mm (range, 11.2 to 21.0 mm), and it increased by 99% +/- 36% (range, 17% to 153%) on average compared with the contralateral shoulder. The average CC distance was 10.5 +/- 2.5 mm (range, 7.7 to 15.5 mm), and it increased by 30% +/- 30% (range, -9.4% to 90%) at the final follow-up. Compared with immediate postoperative radiographs, the CC distance was maintained in 12 patients, increased between 50% and 100% in 4 patients, and increased more than 100% in 2 patients at final follow-up. However, there was no statistical difference in Constant scores between 6 patients with reduction loss (95.6 +/- 4.5) and 12 patients with reduction maintenance (98.4 +/- 2.5; P = .17). Perioperative complications occurred in 8 patients, including one case of acromioclavicular arthritis, one case of delayed distal clavicular fracture at the clavicular hole of the device, 3 cases of clavicular or coracoid button failures, and 3 cases of clavicular bony erosion. Conclusions: Satisfactory clinical outcomes were obtained after CC fixation using the single adjustableeloop-length suspensory fixation device for acute acromioclavicular joint dislocation. However, CC fixation failure of greater than 50% of the unaffected side in radiological examinations occurred in 33% of the patients within 3 months after the operation. Additionally, 8 patients (44%) had complications associated with the adjustableeloop-length suspensory fixation device and surgical technical problems. Despite acceptable shoulder function restoration, adequate care should be exercised in surgical treatment of acute acromioclavicular dislocation with a single adjustableeloop-length suspensory fixation device for optimal radiological outcomes.