The frequency of reduction loss after arthroscopic fixation of acute acromioclavicular dislocations using a double-button device, and its effect on clinical and radiological results.

Autor: Çarkçı E; Department of Orthopedics and Traumatology, Istanbul Training and Research Hospital, 34098 Fatih, Istanbul, Turkey., Polat AE; Department of Orthopaedics and Traumatology, Dr. Akçiçek State Hospital, 99300, Kyrenia, Cyprus. ayseesinuygur@gmail.com., Gürpınar T; Department of Orthopedics and Traumatology, Istanbul Training and Research Hospital, 34098 Fatih, Istanbul, Turkey.
Jazyk: angličtina
Zdroj: Journal of orthopaedic surgery and research [J Orthop Surg Res] 2020 Apr 08; Vol. 15 (1), pp. 136. Date of Electronic Publication: 2020 Apr 08.
DOI: 10.1186/s13018-020-01674-x
Abstrakt: Background: The aim of this study was to investigate the effect of reduction loss of more than 3 mm on clinical and radiological results after at least 2 years of follow-up after arthroscopic fixation of acute acromioclavicular joint dislocations using a double-button device.
Methods: Thirty-six patients who had acute (< 3 weeks old), type III or V acromioclavicular (AC) joint dislocations underwent arthroscopic fixation of the AC joint using a double-button device. Clinical and radiological evaluations were performed at preoperative, postoperative first day, 3 months and last follow-up. When the coracoclavicular (CC) distances of patients at the last follow-up were compared to the early postop CC distances, those with a difference of 3 mm or less were grouped as group A and those with a difference of more than 3 mm were grouped as group B.
Results: There was no statistically significant difference between the groups in terms of age, gender, follow-up time, time from injury to surgery, return to work, and distribution of Rockwood classification. Pre-operative CC distance was reduced from 18.7 ± 3.5 to 8.5 ± 0.6 in the early postoperative period. Anatomic reduction was achieved in all patients compared with the unaffected side (CC distance 8.6 ± 0.7). However, the CC distance increased to 9.9 ± 1.5 at the third-month follow-up and increased to 11 ± 2.7 at the last follow-up. There were no significant Constant score differences between the groups in the preoperative and last follow-up periods (p > 0.05). At the last follow-up, the mean Acromioclavicular Joint Instability (ACJI) score of group A was 84.4 ± 8, whereas it was 68.3 ± 8.3 for group B, and the difference was statistically significant (p < 0.01). Furthermore, the subjective evaluation and aesthetic subjective satisfaction values of group B were lower than group A (p < 0.01).
Conclusions: Reduction loss of more than 3 mm was observed in 25% of patients after arthroscopic fixation of acute acromioclavicular dislocations using a double-button device. Although this loss did not create a statistically significant difference in Constant scores, AC joint-specific tests such as ACJI, subjective evaluation, and aesthetic subjective satisfaction values were significantly impaired.
Databáze: MEDLINE
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