title: Operative treatment of acute acromioclavicular dislocations Rockwood III and V-Comparative study between K-wires combined with FiberTape(®) vs. TightRope System(®).
abstract: BACKGROUND
  Acromioclavicular (AC) joint dislocations usually occur in a young active population as a result of a fall on the shoulder. Rockwood divided these dislocations into six types. Optimal treatment is still a matter of discussion. Many operative techniques have been developed, but the main choice is between open and minimally-invasive arthroscopic procedures. The aim of this study was to compare two different surgical methods on two groups of patients to find out which method is superior in terms of benefit to the patient. The methods were evaluated through objective and subjective scores, with a focus on complications and material costs.
  
  
  METHODS
  A retrospective two-centre study was conducted in patients with acute AC joint dislocation Rockwood types III and V. The two methods conducted were an open procedure using K-wires combined with FiberTape(®) (Arthrex, Naples, USA) (Group 1) and an arthroscopic procedure using the TightRope System(®) (Arthrex, Naples, USA) (Group 2). Groups underwent procedures during a two-year period. Diagnosis was based on the clinical and radiographic examination of both AC joints. Surgical treatment and rehabilitation were performed.
  
  
  RESULTS
  Sixteen patients were included in this study: Group 1 comprised 10 patients, all male, average age 41.6 years (range 17-64 years), Rockwood type III (eight patients) and Rockwood type V (two patients); Group 2 had six patients, one female and five male, average age 37.8 years (range 18-58 years), Rockwood type III (two patients) and Rockwood type V (four patients). Time from injury to surgery was shorter and patients needed less time to return to daily activities in Group 1. Duration of the surgical procedure was shorter in Group 2 compared with Group 1. Complications of each method were noted. According to the measured scores and operative outcome between dislocation Rockwood type III and V, no significant difference was found. Implant material used in Group 2 was 4.7 times more expensive than that used in Group 1.
  
  
  CONCLUSIONS
  Both methods offer many advantages with satisfying evaluated scores. K-wires with FiberTape(®) offer a shorter period for complete recovery and a significantly more cost-effective outcome, whereas the TightRope System(®) offers shorter operative procedure, better cosmetic result and avoidance of intraoperative fluoroscopy.
authors.affiliation: Department of Orthopaedic Surgery, University Hospital "Sveti Duh", Sveti Duh 64, Zagreb, Croatia. Electronic address: gvrgoc@gmail.com.
authors.forename: G
authors.initials: G
authors.lastname: Vrgoč
authors.affiliation: Clinic for Surgery, Department of General and Sports Traumatology, University Hospital "Merkur", Zagreb, Croatia.
authors.forename: M
authors.initials: M
authors.lastname: Japjec
authors.affiliation: Clinic for Traumatology, Department of University Clinical Hospital Centre "Sestre Milosrdnice", Zagreb, Croatia.
authors.forename: P
authors.initials: P
authors.lastname: Jurina
authors.affiliation: Clinic for Orthopaedic Surgery "Lovran", School of Medicine, University of Rijeka, Rijeka, Croatia.
authors.forename: G
authors.initials: G
authors.lastname: Gulan
authors.affiliation: Department of Orthopaedic Surgery, University Hospital "Sveti Duh", Sveti Duh 64, Zagreb, Croatia.
authors.forename: S
authors.initials: S
authors.lastname: Janković
authors.affiliation: Clinic for Surgery, Department of General and Sports Traumatology, University Hospital "Merkur", Zagreb, Croatia.
authors.forename: B
authors.initials: B
authors.lastname: Šebečić
authors.affiliation: Clinic for Surgery, Department of General and Sports Traumatology, University Hospital "Merkur", Zagreb, Croatia.
authors.forename: M
authors.initials: M
authors.lastname: Starešinić
mesh_terms: D000173:Acromioclavicular Joint / Q000293:injuries / Q000503:physiopathology / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D001182:Arthroscopy; D001864:Bone Wires; D017523:Croatia / Q000453:epidemiology; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D012783:Shoulder Dislocation / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D053832:Surgical Tape; D053441:Suture Anchors; D016896:Treatment Outcome
keywords: AC joint; Acromioclavicular dislocation; FiberTape(®); K-wire; TightRope System(®)