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Updated: May 14, 2026

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Acromio-clavicular repair using two different techniques.

Lorenzo Andreani1, Enrico Bonicoli, Paolo Parchi

  • 1Orthopedics and Tramatology I Department, University of Pisa, via Paradisa 2, 56121, Pisa, Italy, l.andreani@hotmail.it.

European Journal of Orthopaedic Surgery & Traumatology : Orthopedie Traumatologie
|February 16, 2013
PubMed
Summary

Acromio-clavicular joint (ACJ) injuries are common in athletes. The tight-rope system offers satisfactory results for ACJ separation, avoiding additional surgery unlike the hook plate.

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Area of Science:

  • Orthopedic Surgery
  • Sports Medicine
  • Traumatology

Background:

  • Acromio-clavicular joint (ACJ) injuries constitute a significant portion of athletic shoulder injuries.
  • Joint stability relies on intact acromio-clavicular and coracoclavicular ligaments.
  • ACJ separation management involves diverse classifications, diagnostics, and surgical implants.

Purpose of the Study:

  • To review recent literature on acromio-clavicular joint injuries.
  • To compare the outcomes of two surgical techniques: the tight-rope system and the hook plate.
  • To evaluate patient return to activity and complication rates.

Main Methods:

  • Retrospective study of patients treated between January 2007 and February 2011.
  • Comparison of tight-rope system versus hook plate techniques performed by a single senior surgeon.

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  • Assessment using the Constant score and final follow-up evaluation.

    • Main Results:

    • The tight-rope system group achieved a mean Constant score of 90, compared to 75 for the hook plate group.
    • Most patients returned to their pre-injury activity levels.
    • Two cases of fixating system breakage occurred; otherwise, satisfactory results with no loss of reduction were observed.

    Conclusions:

    • Both techniques yielded satisfactory outcomes for ACJ separation.
    • The hook plate is suitable for fracture-dislocations but necessitates hardware removal.
    • The tight-rope system offers advantages by avoiding additional surgery and the need for grafts.