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Comparison between Tightrope and Hook Plate Techniques in the Treatment of Acromioclavicular Joint Dislocations: A
Saud Nayef Salem Aldanyowi1, Abdulsalam Mohammed Aleid1, Yousef Khalaf A Alghamdi2
1Department of Surgery, Medical College, King Faisal University, Hofuf, Ahsa, 31982, Saudi Arabia.
Introduction:
Acromioclavicular joint (ACJ) dislocations are common, particularly in athletes. Surgical treatments, including tightrope (TR) and hook plate (HP) techniques, are frequently used, yet no consensus exists on the most effective approach. This study aimed to compare TR and HP methods for managing ACJ dislocations.
Methods:
Following PRISMA guidelines, we conducted a systematic review of PubMed, Scopus, and Web of Science databases, including randomized controlled trials, cohort, and case-control studies. Statistical analysis was performed using RevMan software.
Results:
A total of 10 studies with 285 patients in the TR group and 355 in the HP group were analyzed. The TR technique showed a significant reduction in pain (MD=-0.3, p =0.04) and lower blood loss (MD=-36.14, p <0.00001) compared to the HP method. No significant differences were noted in shoulder function (Constant-Murley score: MD=-0.14, p =0.95), joint stability (coracoclavicular distance: MD=0.47, p =0.41), or patient satisfaction (ASES: MD=-2.28, p =0.67).
Discussion:
Both techniques offered similar functional and stability outcomes, yet TR presented clear benefits in pain management and reduced blood loss. These advantages suggest that TR may be a better option for minimizing complications and improving recovery. The comparable results in shoulder function and stability implied that surgeon preference and patient-specific factors should guide the choice of technique.
Conclusion:
TR provided superior pain relief, less intraoperative blood loss, and fewer implantrelated complications compared to HP, while both methods offered similar outcomes in functional recovery and satisfaction.