Arthroscopic treatment of acute acromioclavicular joint dislocation with double flip button.

The ideal treatment for acute acromioclavicular joint dislocation is still controversial, both in terms of indications and surgical technique. The clinical and radiographic outcomes of 16 patients affected by acute AC joint dislocation (type III-V) and arthroscopically treated with a coracoclavicular double flip button are presented. Despite the excellent clinical results both in terms of Constant score (mean 97 points) and patient satisfaction, at a mean follow-up of 31 months the radiographs showed partial loss of reduction due to distal migration of the flip button within the upper third of the clavicle in one-fourth of the cases. The technique presented here proved to be safe and minimally invasive while delivering good aesthetic results and allowing for the treatment of associated lesions. Furthermore, the technique could benefit from more advanced retention devices, which ought to reduce or avoid migration of the flip buttons.

Clinical and ultrasound results after arthroscopic repair of the rotator cuff.

The literature reports good functional results obtained with arthroscopic repair of the rotator cuff, but the incidence of anatomical healing has not been sufficiently studied. Ultrasound examination makes it possible to accurately document the healing process of the tendon at the bone, gathering information that may be useful in a comparison with clinical data. A total of 43 consecutive arthroscopic repairs of rotator cuff injuries were considered, that had made use of anchors and non-resorbable suturing. A total of 42 patients were willing to undergo clinical monitoring with an associated ultrasound examination after 3, 6 and 12 months. When ultrasound examination after 6 and 12 months was carried out, 36 patients presented with anatomical healing of the rotator cuff. The total percentage of repair failures was 14.3% and increased to 23% if we take into consideration the subscapular tendon alone. Constant score went from a preoperative mean of 51.25 to a mean of 78.21 after 12 months (p<0.001). Arthroscopic repair of the rotator cuff leads to anatomical healing of the tendons in a high percentage of cases, obtaining good functional results. The absence of healing is associated with lower values for recovery of strength at clinical follow-up. The advanced age of the patients (p<0.001) and the extensive injuries that involve several tendons (p=0.002) are negative prognostic factors.