Acute high-grade acromioclavicular dislocations treated with triple button device (MINAR): Preliminary results

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Traumatology

Background:

• High-grade acromioclavicular (AC) joint dislocations, specifically Rockwood type V, present significant challenges in restoring shoulder stability.
• Traditional surgical techniques for AC joint dislocations often involve complex procedures with varying degrees of success and potential complications.

Purpose of the Study:

• To evaluate the clinical and radiological outcomes of the triple button device (Twin Tail TightRope™ system) for treating Rockwood type V AC dislocations.
• To assess the system's efficacy in improving vertical and horizontal shoulder stability compared to previously described methods.

Main Methods:

• Retrospective analysis of 33 patients with type V AC dislocations treated with the Twin Tail TightRope™ system.
• Clinical assessment using Constant Score (CS) and Acromioclavicular Joint Instability Scoring System (ACJI).
• Radiographic evaluation including coracoclavicular (CC) and AC distances (Zanca and Alexander views) pre- and post-operatively.

Main Results:

• Mean follow-up of 25 months showed high clinical scores (CS: 94.1, ACJI: 87.3), comparable to the uninjured shoulder.
• Significant improvement in CC distance (21.75mm to 8.73mm) and AC distance (12.65mm to 0.35mm) with no loss of vertical reduction.
• Posterior instability noted in 4 patients (12.12%); implant mobilization, calcification, or degenerative changes did not correlate with poorer outcomes.

Conclusions:

• The Twin Tail TightRope™ system, utilizing a minimally invasive technique, effectively enhances shoulder stability in both vertical and horizontal planes for high-grade AC dislocations.
• This device offers an improved alternative to previous techniques without a significant increase in complications.