Comparative study of two different horizontal stabilisation methods in arthroscopically assisted coracoclavicular stabilisation for acute acromioclavicular joint dislocations-Good clinical outcome and no correlation to recurrent anteroposterior instability.

ABSTRACT

PURPOSE: The hypothesis of this study was that acromioclavicular K-wire transfixation is noninferior to horizontal FiberTape cerclage in terms of vertical and horizontal stability in the short follow-up period of acute acromioclavicular joint (ACJ) dislocations fixed with an arthroscopically assisted coracoclavicular single bundle endobutton cerclage system. The secondary aim was to investigate the impact of postoperative recurrent instability on clinical outcomes in these populations. METHODS: In this consecutive clinical trial, all patients who underwent surgery for acute AC joint dislocation between January 2017 and December 2021 were included. Two groups were formed according to the additional AC stabilisation technique (K-wire group, cerclage group). Clinical examination and bilateral radiologic analysis (Zanca stress view, Alexander view) were performed with a follow-up period of at least 12 months. Satisfaction, return to sports, active range of motion, global shoulder scores and specific shoulder scores including constant score, disabilities of the arm, shoulder and hand (DASH) score and ACJ instability score (ACJI) were evaluated. Complications, including recurrent instability, and revision rate were assessed. RESULTS: Included were 59 patients (32 K-wire group, 27 cerclage group, 92% male, median follow-up 33 months). No significant differences were found in the clinical outcome parameters between the different techniques, except for the DASH value (superior in the K-wire group). Recurrent anteroposterior instability was radiographically detected in 27% of patients. No correlation was found between anteroposterior instability and clinical outcome parameters. There was no revision surgery due to chronic ACJ instability. CONCLUSION: Horizontal ACJ stabilisation with temporary K-wire transfixation does not appear to be inferior to a FiberTape cerclage technique in acute ACJ dislocations stabilised in an arthroscopically assisted single bundle DogBone technique. Recurrent ACJ instability detected radiographically does not necessarily correlate with the functional outcome and can be well compensated. LEVEL OF EVIDENCE Level III.