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Hook plate fixation with coracoclavicular suspensory suture augmentation for Rockwood grade V acromioclavicular joint dislocation in recreational sports activity
Arthrosc Orthop Sports Med 2022;9:57-66
Published online November 1, 2022;  https://doi.org/10.14517/aosm22017
© 2022 Korean Arthroscopy Society and Korean Orthopedic Society for Sports Medicine.

Sun-Kyu Kim*, Jewon Jung*, Min Soo Shon

Department of Orthopedic Surgery, National Medical Center, Seoul, Korea
Correspondence to: Min Soo Shon, https://orcid.org/0000-0002-0012-595X
Department of Orthopedic Surgery, National Medical Center, 245 Eulji-ro, Jung-gu, Seoul 04564, Korea. Tel: +82-2-2260-7198, Fax: +82-2-2278-9570, E-mail: minsoo.shon@nmc.or.kr
*These authors contributed equally to this work as co-first authors.
Received September 6, 2022; Revised October 7, 2022; Accepted October 10, 2022.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: This study aimed to investigate the outcomes of hook plate fixation with coracoclavicular (CC) suspensory suture augmentation for acute Rockwood grade V acromioclavicular joint (ACJ) dislocation in patients engaging in recreational activity.
Methods: This retrospective study was performed on 25 patients who underwent hook plate fixation combined with CC suspensory suture augmentation for acute Rockwood grade V ACJ dislocation that occurred during recreational activity in National Medical Center. Clinical outcomes and patient-rated satisfaction were assessed on the final follow-up. Radiographic changes, including CC distance (CCD) and proportional length differences (PLD), were assessed at the preoperative, first (i.e., immediately after implant removal), and final evaluation times.
Results: After a mean of 23.7 months for final follow-up, the mean numeric rating scale for pain, Constant–Murley, University of California at Los Angeles, and American Shoulder and Elbow Surgeons scores were 0.9, 91.2, 30.8, and 86.7 respectively, and only one patient subjectively complained of shoulder stiffness. Compared with the mean preoperative CCD (17.5 mm) and PLD (155.4%), the CCD (P < 0.001, 7.9 mm) and PLD (P < 0.001, 3.7%) significantly improved at the first evaluation time (mean 6.1 mo). There were no significant deteriorations in the mean CCD and PLD on the serial evaluations (P = 0.107). Minimal erosion around the hook was observed in five patients, all of which were asymptomatic. There were no other major complications. All patients returned to their recreational activity level before the index injury. Patient-rated satisfaction was good to excellent.
Conclusion: This study demonstrated good clinical outcomes and relatively less complications after hook plate fixation with CC suspensory suture augmentation for acute Rockwood grade V ACJ dislocation in patients engaging in recreational activity. On serial follow-ups, radiographic outcome was maintained without significant additional displacement, even after the CC-augmented sutures and the plate removal.
Keywords : Acromioclavicular joint; Coracoclavicular ligament; Acromioclavicular joint dislocation; Hook plate; Suspensory suture augmentation
References
  1. Chillemi C, Franceschini V, Dei Giudici L, et al. Epidemiology of isolated acromioclavicular joint dislocation. Emerg Med Int 2013;2013:171609.
    Pubmed KoreaMed CrossRef
  2. Gilot G, Mutnal AB, Owens J. Epidemiology, clinical evaluation, imaging, and classification of acromioclavicular joint injuries. In: Zuckerman JD, Iannotti JP, Miniaci A, Williams GR, editors. Disorders of the shoulder: diagnosis and management. Volume 3, Shoulder trauma. 3rd ed. Baltimore, MD: Lippincott Williams & Wilkins; 2014. p.207-17.
  3. Babhulkar A, Pawaskar A. Acromioclavicular joint dislocations. Curr Rev Musculoskelet Med 2014;7:33-9.
    Pubmed KoreaMed CrossRef
  4. Pallis M, Cameron KL, Svoboda SJ, Owens BD. Epidemiology of acromioclavicular joint injury in young athletes. Am J Sports Med 2012;40:2072-7.
    Pubmed CrossRef
  5. Hibberd EE, Kerr ZY, Roos KG, Djoko A, Dompier TP. Epidemiology of acromioclavicular joint sprains in 25 National Collegiate Athletic Association Sports: 2009-2010 to 2014-2015 academic years. Am J Sports Med 2016;44:2667-74.
    Pubmed CrossRef
  6. Diaz CC, Forlenza EM, Lavoie-Gagne OZ, et al. Acromioclavicular joint separation in UEFA soccer players: a matched-cohort analysis of return to play and player performance from 1999 to 2018. Orthop J Sports Med 2021;9:23259671211026262.
    Pubmed KoreaMed CrossRef
  7. Leahy TM, Kenny IC, Campbell MJ, et al. Epidemiology of shoulder injuries in schoolboy rugby union in Ireland. Orthop J Sports Med 2021;9:23259671211023431.
    Pubmed KoreaMed CrossRef
  8. Dragoo JL, Braun HJ, Bartlinski SE, Harris AH. Acromioclavicular joint injuries in National Collegiate Athletic Association football: data from the 2004-2005 through 2008-2009 National Collegiate Athletic Association Injury Surveillance System. Am J Sports Med 2012;40:2066-71.
    Pubmed CrossRef
  9. Tamaoki MJ, Lenza M, Matsunaga FT, Belloti JC, Matsumoto MH, Faloppa F. Surgical versus conservative interventions for treating acromioclavicular dislocation of the shoulder in adults. Cochrane Database Syst Rev 2019;10:CD007429.
    CrossRef
  10. Jeong JY, Chun YM. Treatment of acute high-grade acromioclavicular joint dislocation. Clin Shoulder Elb 2020;23:159-65.
    Pubmed KoreaMed CrossRef
  11. Nolte PC, Lacheta L, Dekker TJ, Elrick BP, Millett PJ. Optimal management of acromioclavicular dislocation: current perspectives. Orthop Res Rev 2020;12:27-44.
    Pubmed KoreaMed CrossRef
  12. Di Francesco A, Zoccali C, Colafarina O, Pizzoferrato R, Flamini S. The use of hook plate in type III and V acromio-clavicular Rockwood dislocations: clinical and radiological midterm results and MRI evaluation in 42 patients. Injury 2012;43:147-52.
    Pubmed CrossRef
  13. Takase K, Hata Y, Morisawa Y, et al. Treatment of acromioclavicular joint separations in Japan: a survey. JSES Int 2020;5:51-5.
    Pubmed KoreaMed CrossRef
  14. Frank RM, Cotter EJ, Leroux TS, Romeo AA. Acromioclavicular joint injuries: evidence-based treatment. J Am Acad Orthop Surg 2019;27:e775-88.
    Pubmed CrossRef
  15. McConnell AJ, Yoo DJ, Zdero R, Schemitsch EH, McKee MD. Methods of operative fixation of the acromio-clavicular joint: a biomechanical comparison. J Orthop Trauma 2007;21:248-53.
    Pubmed CrossRef
  16. Chiang CL, Yang SW, Tsai MY, Kuen-Huang Chen C. Acromion osteolysis and fracture after hook plate fixation for acromioclavicular joint dislocation: a case report. J Shoulder Elbow Surg 2010;19:e13-5.
    Pubmed CrossRef
  17. ElMaraghy AW, Devereaux MW, Ravichandiran K, Agur AM. Subacromial morphometric assessment of the clavicle hook plate. Injury 2010;41:613-9.
    Pubmed CrossRef
  18. Lin HY, Wong PK, Ho WP, Chuang TY, Liao YS, Wong CC. Clavicular hook plate may induce subacromial shoulder impingement and rotator cuff lesion--dynamic sonographic evaluation. J Orthop Surg Res 2014;9:6.
    Pubmed KoreaMed CrossRef
  19. Nadarajah R, Mahaluxmivala J, Amin A, Goodier DW. Clavicular hook-plate: complications of retaining the implant. Injury 2005;36:681-3.
    Pubmed CrossRef
  20. Oh HS, Kim S, Hyun JH, Kim MS. Effect of subacromial erosion shape on rotator cuff and clinical outcomes after hook plate fixation in type 5 acromioclavicular joint dislocations: a retrospective cohort study. BMC Musculoskelet Disord 2022;23:42.
    Pubmed KoreaMed CrossRef
  21. Arirachakaran A, Boonard M, Piyapittayanun P, et al. Post-operative outcomes and complications of suspensory loop fixation device versus hook plate in acute unstable acromioclavicular joint dislocation: a systematic review and meta-analysis. J Orthop Traumatol 2017;18:293-304.
    Pubmed KoreaMed CrossRef
  22. Lim TK, Shon MS, Ryu HG, et al. Coracoclavicular ligament suture augmentation with anatomical locking plate fixation for distal clavicle fracture. Clin Shoulder Elb 2014;17:175-80.
    CrossRef
  23. Chang HM, Hong CK, Su WR, Wang TH, Chang CW, Tai TW. Comparison of clavicular hook plate with and without coracoclavicular suture fixation for acute acromioclavicular joint dislocation. Acta Orthop Traumatol Turc 2019;53:408-13.
    Pubmed KoreaMed CrossRef
  24. Lee CY, Chen PC, Liu YC, et al. Does coracoclavicular augmentation additional to hook plate fixation provide benefits in acute unstable acromioclavicular dislocation? A meta-analysis. BMC Musculoskelet Disord 2022;23:205.
    Pubmed KoreaMed CrossRef
  25. Rockwood CA Jr. Fractures and dislocations of the shoulder. In: Rockwood CA Jr, Green DP, editors. Fractures in adults. 2nd ed. Philadelphia, PA: Lippincott; 1984. p.860-910.
  26. Leong NL, Kator JL, Clemens TL, James A, Enamoto-Iwamoto M, Jiang J. Tendon and ligament healing and current approaches to tendon and ligament regeneration. J Orthop Res 2020;38:7-12.
    Pubmed KoreaMed CrossRef
  27. Chen YT, Wu KT, Jhan SW, et al. Is coracoclavicular reconstruction necessary in hook plate fixation for acute unstable acromioclavicular dislocation? BMC Musculoskelet Disord 2021;22:127.
    Pubmed KoreaMed CrossRef
  28. Kim SJ, Kee YM, Park DH, Ko YI, Lee BG. Evaluation of the acromioclavicular joint morphology for minimizing subacromial erosion after surgical fixation of the joint using a clavicular hook plate. Clin Shoulder Elb 2018;21:138-44.
    Pubmed KoreaMed CrossRef
  29. Qiao R, Yang J, Zhang K, Song Z. To explore the reasonable selection of clavicular hook plate to reduce the occurrence of subacromial impingement syndrome after operation. J Orthop Surg Res 2021;16:180.
    Pubmed KoreaMed CrossRef
  30. Del Sol SR, Dela Rueda T, Perinovic S, et al. Anchorless acromioclavicular and coracoclavicular ligament repair using a graftpassing instrument to pass suture under the coracoid. Arthrosc Tech 2021;11:e53-60.
    Pubmed KoreaMed CrossRef

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