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Die arthroskopisch unterstützte Stabilisierung der akuten AC-Gelenksprengung

Vergleich der klinischen und radiologischen Ergebnisse der Single- vs. Double-TightRope™-Technik

Arthroscopically assisted reduction of acute acromioclavicular joint separations

Comparison of clinical and radiological results of single versus double TightRope™ technique

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Zusammenfassung

Hintergrund

Ziel der Studie war es, bei der arthroskopischen Stabilisierung der akuten akromioklavikulären (AC-)Gelenkluxation die Verwendung von einem Single-TightRope™ (STR) vs. zwei Double-TightRope™- (DTR-)Implantaten zu vergleichen, mit der Hypothese, dass DTR eine geringere korakoklavikulären (CC-)Distanz erzielt.

Patienten und Methoden

Es wurden 29 konsekutive mit TR operierte Patienten (d = 38,1 Jahre; n = 26 männlich) im Rahmen einer Kohortenstudie mit einem Follow-up von 13,3 (12,0–21,7) Monaten nachuntersucht. Eingeschlossen wurden die akute AC-Gelenksprengung Typ III und V nach Rockwood®. Es erfolgte eine Auswertung der prospektiv präoperativ, 3, 6 und 12 Monate postoperativ erhobenen Scores und Röntgenbildgebung.

Ergebnisse

Eine Rockwood- (R-)III-Verletzung erlitten 12 Patienten, 17 eine R-V-Verletzung; 14 wurden mit STR stabilisiert, 15 mit DTR. Mit STR wurden 8 R-III- und 6 R-V-Verletzungen, mit DTR 4 R-III- und 11 R-V-Verletzungen adressiert. STR erzielte in 5 Fällen (36%) eine CC-Distanz von > 125% im Vergleich zur gesunden Gegenseite, wovon 2 eine R-V- und 3 eine R-III-Verletzung darstellten. Mit DTR lag die CC-Distanz in 2 Fällen (13%) einer R-V-Verletzung >125%.

Schlussfolgerung

Die DTR-Technik erzielte eine geringere CC-Distanz ohne signifikanten Unterschied der gemittelten CC-Distanz und der Scores in der Jahreskontrolle.

Abstract

Background

The aim of this study was to compare the results of the single (STR) versus double TightRope™ (DTR) technique for stabilisation of acute separations of the AC joint with the hypothesis that DTR achieves lower CC distance.

Patients and methods

A total of 29 consecutive patients treated operatively with the TR technique (mean age 38.1 years, n=26 male) were analysed in a cohort study with a mean follow-up of 13.3 months (12.0–21.7). Acute AC joint separations types III and V according to Rockwood (R) were included; R types I, II, IV and VI were excluded. The prospective scores determined pre-op and 3, 6 and 12 months post-op and X-rays were evaluated.

Results

Of the patients 12 suffered an R type III and 17 an R V separation; 14 were treated with STR and 15 with DTR. With STR, 8 R III and 6 R V injuries and with DTR 4 R III and 11 R V injuries were treated arthroscopically. STR achieved an increased CC distance >125% compared to the contralateral AC joint in five cases (36%). Two of them occurred as R V and three as R III injury. DTR achieved a CC distance >125% in two cases of an R V injury (13%).

Conclusion

The DTR technique provides lower CC distance compared to the STR technique, without a significant difference of CC distance and scores.

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Danksagung

Wir danken Dr. Nina Timmesfeld vom Institut für Medizinische Biometrie und Epidemiologie der Universität Marburg für die Unterstützung bei der statistischen Auswertung.

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

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Authors and Affiliations

  1. Orthopädische Klinik, Universitätsklinikum Düsseldorf, Moorenstraße 5, 40223, Düsseldorf, Deutschland

    T. Patzer

  2. Klinik für Unfall-, Hand-, und Wiederherstellungschirurgie, Universitätsklinikum Marburg, Marburg, Deutschland

    C. Clauss, C.A. Kühne, E. Ziring, S. Ruchholtz & D. Mann

  3. Klinik für Orthopädie und Rheumatologie, Universitätsklinikum Marburg, Marburg, Deuschland

    T. Efe

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  1. T. Patzer
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Correspondence to T. Patzer.

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Patzer, T., Clauss, C., Kühne, C. et al. Die arthroskopisch unterstützte Stabilisierung der akuten AC-Gelenksprengung. Unfallchirurg 116, 442–450 (2013). https://doi.org/10.1007/s00113-011-2135-2

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