Staff Members - Benha University
Open versus modified arthroscopic treatment of acute acromioclavicular dislocation using a single tight rope: Randomized comparative study of clinical outcome and cost-effectiveness
Journal of Shoulder and Elbow Surgery. • 2019
Publication Information
Authors
Amr A. Abdelrahman, MDa, Amr Ibrahim, MDa, Khalid Abdelghaffar, MDa,
Tarek Mohamed Ghandour, MDa,*, Diaa Eldib, MDb
Keywords
Acromioclavicular; dislocation; TightRobe; shoulder; arthroscopy; Rockwood
Journal
Journal of Shoulder and Elbow Surgery.
Publisher
Elsevier
Volume
Not Available
Issue
Not Available
Pages
Not Available
publication.type
International
Paper Link
Not Available
Supplementary Materials
Not Available
Abstract
Purpose: The purpose of this study was to compare clinical outcome and cost-effectiveness between arthroscopic and open repair using Tightrope in acromioclavicular joint dislocation III and IV.
Patients and methods: Fifty-two patients with acute acromioclavicular joint dislocation type III and IV were included. Patients were randomly allocated to either of 2 groups: Arthroscopic Repair Group(ARG) and Open Repair Group (ORG). Constant-Murley Score (CMS), visual analog scale (VAS)score, and coracoclavicular (CC) distance were measured preoperatively and 3 months, 6 months, 1year, and 2 years postoperatively.
Results: CMS increased from 40.68 for the ARG and 40.70 for the ORG preoperatively to 84.18 and 84.45 after 2 years from operation. VAS score decreased from 60.59 for the ARG and 64.50 for the ORG 1 day after surgery to 18.04 and 17.87 respectively after 6 months. CC distance decreased from 29.27 mm in the ARG and 28.16 mm in the ORG preoperatively to 9.86 mm in the ARG and 10.54 mm in the ORG on postoperative day 1. Rewidening of the CC distance occurred after 6 months
(13.27 mm for the ARG and 13.62 mm for the ORG) and 1 year postoperatively (15.77 for the ARG and 15.41 for the ORG) but remained stable at final follow-up. There was a significant difference in surgical time (80.00 minutes in the ARG compared to 52.79 minutes in the ORG) and cost of consumables (US$1729.95 in the ARG compared to US$851.87 in the ORG).
Conclusion: Open and arthroscopic repair of acute acromioclavicular joint dislocation yielded good clinical results, yet the arthroscopic technique is more expensive and has a longer surgical time.
Patients and methods: Fifty-two patients with acute acromioclavicular joint dislocation type III and IV were included. Patients were randomly allocated to either of 2 groups: Arthroscopic Repair Group(ARG) and Open Repair Group (ORG). Constant-Murley Score (CMS), visual analog scale (VAS)score, and coracoclavicular (CC) distance were measured preoperatively and 3 months, 6 months, 1year, and 2 years postoperatively.
Results: CMS increased from 40.68 for the ARG and 40.70 for the ORG preoperatively to 84.18 and 84.45 after 2 years from operation. VAS score decreased from 60.59 for the ARG and 64.50 for the ORG 1 day after surgery to 18.04 and 17.87 respectively after 6 months. CC distance decreased from 29.27 mm in the ARG and 28.16 mm in the ORG preoperatively to 9.86 mm in the ARG and 10.54 mm in the ORG on postoperative day 1. Rewidening of the CC distance occurred after 6 months
(13.27 mm for the ARG and 13.62 mm for the ORG) and 1 year postoperatively (15.77 for the ARG and 15.41 for the ORG) but remained stable at final follow-up. There was a significant difference in surgical time (80.00 minutes in the ARG compared to 52.79 minutes in the ORG) and cost of consumables (US$1729.95 in the ARG compared to US$851.87 in the ORG).
Conclusion: Open and arthroscopic repair of acute acromioclavicular joint dislocation yielded good clinical results, yet the arthroscopic technique is more expensive and has a longer surgical time.