Clinical efficacy of arthroscopic-assisted anchor fixation VS hook plate for the treatment of acute acromioclavicular joint dislocation

Abstract Objective To compare the clinical efficacy and imaging outcomes of hook plate fixation versus arthroscopically assisted coracoclavicular ligament reconstruction with two anchors for acute acromioclavicular joint dislocation (Rockwood III-V). Methods Ninety-eight patients with acute acromioclavicular joint dislocation (Rockwood III-V) who were admitted between January 2016 and June 2022 were included in the study. Patients were treated with either arthroscopically assisted coracoclavicular ligament reconstruction using two anchors or open reduction and hook plate fixation. Radiological findings were recorded at 3 months, 6 months, 1 year, and 2 years postoperatively, and shoulder function was evaluated using the ASES and Constant scores. Pain was evaluated using the VAS score, and shoulder range of motion was recorded. Results The study included 79 male and 19 female patients, with 37 left-side and 61 right-side dislocations. The patients' ages ranged from 21 to 60 years, with a mean age of 37.6 years. Fifty-five patients underwent arthroscopically assisted coracoclavicular ligament reconstruction using two metal anchors, and 43 patients underwent open reduction and hook plate fixation. The mean follow-up period was 25.4 months. At 3 and 6 months postoperatively, the pain scores in the anchor group were significantly lower than those in the hook plate group. There was no significant difference in pain scores between the two groups at 1 and 2 years postoperatively. At 3 and 6 months postoperatively, the ASES and Constant scores in the anchor group were significantly higher than those in the hook plate group. There was no significant difference in ASES and Constant scores between the two groups at 1 and 2 years postoperatively. At 3 and 6 months postoperatively, the anchor group showed significantly better forward flexion and external rotation than the hook plate group. There was no significant difference in flexion and external rotation between the two groups at 1 and 2 years postoperatively. At 3 months, 6 months, 1 year and 2 years after surgery, there was no statistical difference in internal rotation between the two groups.Two patients in the anchor group had complete loss of reduction at 1-month follow-up. One patient in the hook plate group had internal fixation loosening. Conclusion Arthroscopically assisted coracoclavicular ligament reconstruction using two metal anchors is an effective method for the treatment of acute acromioclavicular joint dislocation. This technique provides earlier restoration of shoulder function with less pain compared to hook plate fixation, and it can reduce surgical trauma and improve surgical efficiency.