Arthroscopic dual-reduction fixation for acromioclavicular joint dislocation: transosseous and half-cerclage fixation outcomes.

backgroundTo our knowledge, this is the first clinical outcome study of the arthroscopic dual-reduction fixation technique combining transosseous and U-shaped half-cerclage suspensory constructs for acromioclavicular joint dislocation(ACJ). This study evaluates the clinical outcomes of an arthroscopic dual-reduction fixation technique for the treatment of ACJ dislocation and compares it with the traditional single bundle coracoclavicular (CC) ligament reconstruction.

methodsThis retrospective study included 30 patients with acute acromioclavicular joint dislocation, divided into an arthroscopic dual-reduction fixation group (Group 1, n = 12) and a traditional suture-button reconstruction with a looped clavicular plate group (Group 2, n = 18). All patients were followed up postoperatively for at least 6 months. Postoperative evaluations were performed using patient-reported outcome measures (PROMs) to assess shoulder joint function and pain relief. Changes in shoulder joint range of motion (ROM) were recorded and compared between the two groups. Additionally, X-ray imaging was used to measure the coracoclavicular distance (CCD) and the extent of the clavicular bone tunnel widening (CBTW) in both groups, assessing the reduction and stability of the ACJ. Postoperative complications were also recorded and analyzed for both groups.

resultsThe body mass index (BMI) and surgical duration in Group 1 were significantly higher than those in Group 2, while the follow-up period in Group 2 was significantly longer than in Group 1. In terms of functional scores, no significant differences were found between the two groups at any follow-up time point. However, the VAS score at 3 months postoperatively was significantly lower in Group 1 than in Group 2 (P < 0.05). Regarding shoulder joint ROM recovery, Group 1 demonstrated more significant improvement at 3 months postoperatively compared to Group 2 (P < 0.05). Radiographic findings showed that the CCD at 6 months postoperatively was significantly smaller in Group 1 compared to Group 2 (P < 0.05), and the degree of bone tunnel enlargement was notably smaller. In terms of complications, Group 1 had only one case of complication, while Group 2 had nine cases of recurrence of instability, AC arthritis, and implant sinking or migration.

conclusionArthroscopic dual-reduction fixation was associated with the combined use of transosseous passage and a U-shaped half-cerclage suspensory construct fixation, with improved maintenance of reduction, less clavicular tunnel enlargement, and fewer complications compared with traditional single-bundle reconstruction in the early postoperative period.