Mid-term clinical and radiological outcomes of coracoclavicular ligament reconstruction with ZipTight Fixation System in the treatment of acute acromioclavicular joint dislocations

E. Uluyardımcı, M. Tahta, Çetin Işık
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Abstract

Objectives: In this study, it was aimed to evaluate the mid-term clinical and radiological outcomes of coracoclavicular (CC) ligament reconstruction using knotless ZipTight fixation system in acute acromioclavicular (AC) joint dislocations. Methods: Twenty-seven patients who underwent surgery with ZipTight (Zimmer Biomet, Parsippany, NJ) fixation system were included in this retrospective clinical study. Twenty-three of the patients are male; 4 of them were female and the mean age was 32.9 ± 9.8. Ten patients had Rockwood type III and 17 patients had type V acute AC joint dislocation. Patients were evaluated clinically with Constant score, American Shoulder and Elbow Surgeons (ASES) score and visual analogue scale (VAS) pain score at the final follow-up. The radiologic assessment included standard anteroposterior views of the coracoclavicular (CC) distances. Results: The mean follow-up time was 36.2 ± 13.6 months. At the last follow-up, mean Constant score was 91.6 ± 6.18; the ASES score was 89.9 ± 6.3 and the VAS pain score was 0.33 ± 0.62. When they were divided into two subgroups as type III and type V AC joint dislocations, the two groups were found to be similar in terms of clinical outcomes (p > 0.889). CC distance measurements obtained in radiographic evaluation were measured as 20.04 ± 4.84 mm at preoperative period; it was 7.55 ± 0.78 mm in the early postoperative period and 7.76 ± 0.79 mm at the last follow-up. A statistically significant improvement was observed in the measurements in the early postoperative period compared to the measurements at preoperative period (p = 0.001). There was no significant difference between the measurements in the early postoperative period and those at the last follow-up (p = 0.001). Conclusions: In the treatment of acute AC joint dislocations, successful clinical and radiological outcomes can be obtained in the mid -term with CC ligament reconstruction using ZipTight fixation system.
ZipTight固定系统重建喙锁韧带治疗急性肩锁关节脱位的中期临床和影像学结果
目的:在本研究中,旨在评估使用无结ZipTight固定系统重建喙锁骨(CC)韧带治疗急性肩锁关节脱位的中期临床和影像学结果。方法:回顾性分析27例采用ZipTight (Zimmer Biomet, Parsippany, NJ)固定系统手术的患者。其中23名患者为男性;其中女性4例,平均年龄32.9±9.8岁。Rockwood III型10例,V型17例。最后随访时采用恒常评分、美国肩关节外科医生(American Shoulder and肘外科医生,ASES)评分和视觉模拟评分(visual analogue scale, VAS)疼痛评分对患者进行临床评估。放射学评估包括喙锁骨(CC)距离的标准正位视图。结果:平均随访36.2±13.6个月。末次随访时,平均Constant评分为91.6±6.18;VAS评分为89.9±6.3分,VAS疼痛评分为0.33±0.62分。将其分为AC关节脱位III型和V型两个亚组,两组临床结局相似(p > 0.889)。术前x线评估的CC距离测量值为20.04±4.84 mm;术后早期为7.55±0.78 mm,末次随访为7.76±0.79 mm。与术前相比,术后早期的测量结果有统计学意义的改善(p = 0.001)。术后早期与最后一次随访时的测量结果无显著差异(p = 0.001)。结论:ZipTight固定系统重建CC韧带治疗急性AC关节脱位,中期临床及影像学效果良好。
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