Treatment of Type V Acromioclavicular Separation with Minimally Invasive Closed-loop Double-endobutton Technique

Background: Acromioclavicular (AC) separation is a prevalent shoulder girdle injury, accounting for 50% of all sports-related shoulder injuries. Surgery is recommended for Rockwood Types IV-VI injuries. In such cases, AC joint congruity and coracoclavicular ligament complex integrity are prerequisit...

Full description

Saved in:
Bibliographic Details
Main Authors: Wei-Hsiang Yang, Yung-Chang Lu, Ting-Kuo Chang, Chung-Ting Liu
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-01-01
Series:Formosan Journal of Musculoskeletal Disorders
Subjects:
Online Access:https://journals.lww.com/10.4103/fjmd.FJMD-D-23-00039
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849762732702695424
author Wei-Hsiang Yang
Yung-Chang Lu
Ting-Kuo Chang
Chung-Ting Liu
author_facet Wei-Hsiang Yang
Yung-Chang Lu
Ting-Kuo Chang
Chung-Ting Liu
author_sort Wei-Hsiang Yang
collection DOAJ
description Background: Acromioclavicular (AC) separation is a prevalent shoulder girdle injury, accounting for 50% of all sports-related shoulder injuries. Surgery is recommended for Rockwood Types IV-VI injuries. In such cases, AC joint congruity and coracoclavicular ligament complex integrity are prerequisites for robust scar tissue healing. Objectives: This study aimed to describe our indirect reduction procedure using a minimally invasive, closed-loop, double endobutton (Tightrope) technique for Type V AC separation and evaluate short-term outcomes and complications. Materials and Methods: A total of 51 patients with Rockwood Type V AC separation underwent surgery using the Tightrope technique between January 2017 and December 2021. Clinical and radiological outcomes were assessed using the Constant–Murley score with documentation of complications. Results: Patients were divided into three groups based on the amount of reduction: Good reduction (16, 31.4%), partial reduction loss (25, 49%) and complete reduction loss (10, 19.6%). Notably, no statistically significant differences were observed between the first two groups. However, the complete reduction loss group demonstrated significantly lower Constant–Murley scores. Conclusions: The Tightrope technique is a promising approach for Rockwood Type V AC separation, yielding favorable clinical outcomes; however, radiographic findings may not be satisfactory. While partial reduction loss had minimal impact, complete loss was associated with inferior results. Therefore, precise tightrope placement and avoidance of coracoid tip positioning are crucial for optimal outcomes.
format Article
id doaj-art-e2b8f06465264fa0ad7d47abeef9aefc
institution DOAJ
issn 2210-7940
2210-7959
language English
publishDate 2025-01-01
publisher Wolters Kluwer Medknow Publications
record_format Article
series Formosan Journal of Musculoskeletal Disorders
spelling doaj-art-e2b8f06465264fa0ad7d47abeef9aefc2025-08-20T03:05:39ZengWolters Kluwer Medknow PublicationsFormosan Journal of Musculoskeletal Disorders2210-79402210-79592025-01-0116181410.4103/fjmd.FJMD-D-23-00039Treatment of Type V Acromioclavicular Separation with Minimally Invasive Closed-loop Double-endobutton TechniqueWei-Hsiang YangYung-Chang LuTing-Kuo ChangChung-Ting LiuBackground: Acromioclavicular (AC) separation is a prevalent shoulder girdle injury, accounting for 50% of all sports-related shoulder injuries. Surgery is recommended for Rockwood Types IV-VI injuries. In such cases, AC joint congruity and coracoclavicular ligament complex integrity are prerequisites for robust scar tissue healing. Objectives: This study aimed to describe our indirect reduction procedure using a minimally invasive, closed-loop, double endobutton (Tightrope) technique for Type V AC separation and evaluate short-term outcomes and complications. Materials and Methods: A total of 51 patients with Rockwood Type V AC separation underwent surgery using the Tightrope technique between January 2017 and December 2021. Clinical and radiological outcomes were assessed using the Constant–Murley score with documentation of complications. Results: Patients were divided into three groups based on the amount of reduction: Good reduction (16, 31.4%), partial reduction loss (25, 49%) and complete reduction loss (10, 19.6%). Notably, no statistically significant differences were observed between the first two groups. However, the complete reduction loss group demonstrated significantly lower Constant–Murley scores. Conclusions: The Tightrope technique is a promising approach for Rockwood Type V AC separation, yielding favorable clinical outcomes; however, radiographic findings may not be satisfactory. While partial reduction loss had minimal impact, complete loss was associated with inferior results. Therefore, precise tightrope placement and avoidance of coracoid tip positioning are crucial for optimal outcomes.https://journals.lww.com/10.4103/fjmd.FJMD-D-23-00039acromioclavicular separationcoracoclavicular stabilizationminimally invasiverange of motionsuture buttontightrope
spellingShingle Wei-Hsiang Yang
Yung-Chang Lu
Ting-Kuo Chang
Chung-Ting Liu
Treatment of Type V Acromioclavicular Separation with Minimally Invasive Closed-loop Double-endobutton Technique
Formosan Journal of Musculoskeletal Disorders
acromioclavicular separation
coracoclavicular stabilization
minimally invasive
range of motion
suture button
tightrope
title Treatment of Type V Acromioclavicular Separation with Minimally Invasive Closed-loop Double-endobutton Technique
title_full Treatment of Type V Acromioclavicular Separation with Minimally Invasive Closed-loop Double-endobutton Technique
title_fullStr Treatment of Type V Acromioclavicular Separation with Minimally Invasive Closed-loop Double-endobutton Technique
title_full_unstemmed Treatment of Type V Acromioclavicular Separation with Minimally Invasive Closed-loop Double-endobutton Technique
title_short Treatment of Type V Acromioclavicular Separation with Minimally Invasive Closed-loop Double-endobutton Technique
title_sort treatment of type v acromioclavicular separation with minimally invasive closed loop double endobutton technique
topic acromioclavicular separation
coracoclavicular stabilization
minimally invasive
range of motion
suture button
tightrope
url https://journals.lww.com/10.4103/fjmd.FJMD-D-23-00039
work_keys_str_mv AT weihsiangyang treatmentoftypevacromioclavicularseparationwithminimallyinvasiveclosedloopdoubleendobuttontechnique
AT yungchanglu treatmentoftypevacromioclavicularseparationwithminimallyinvasiveclosedloopdoubleendobuttontechnique
AT tingkuochang treatmentoftypevacromioclavicularseparationwithminimallyinvasiveclosedloopdoubleendobuttontechnique
AT chungtingliu treatmentoftypevacromioclavicularseparationwithminimallyinvasiveclosedloopdoubleendobuttontechnique