New Variant of the Treatment of Acromion-Clavicular Dislocation With TightRope ® System in a Mini - Open Approach: A Preliminary Clinical Study


1 Orthopedics and Traumatology Unit, Department of Medical Sciences of Basis, Neurosciences and Organs of Sense, Faculty of Medicine and Surgery, University of Study of Bari, General Hospital, Piazza Giulio Cesare, Bari, Italy

2 Berkshire Independent Hospital, Swallows Croft, Wensley Road, Reading, UK



Many different surgical techniques have been described to stabilize the acromion-clavicular (AC) dislocations. So far many of these procedures are performed only in arthroscopy.

In this study, we describe a new technique that utilizes the tightrope with a mini-invasive open approach for the acute stabilization of the acromion-clavicular joint (ACJ) dislocation.

Patients and Methods
We set an prospective study aimed to verify the efficacy of this new surgical technique. We treated 28 patients with acute ACJ dislocation with ACJ TightRope ® System with dual mini access. We retrospectively reviewed the data of 34 patients treated with arthroscopic technique. They were considered as the control group.

At 6 month’s follow-up, all the 28 patients showed a stable joint during clinical examination and obtained an average Constant score of 98.62/100, with a complete recovery of ROM and strength in abduction. The mean operation time was of 33.7 minutes. The mean recovery duration was 102.8 days. No significant difference was found between the experimental and control groups (P > 0.05).

Results of this trial suggest the effectiveness of this new mini-invasive surgical technique in producing clinical and functional recovery in patients with ACJ dislocations.


1. Allman FJ. Fractures and ligamentous injuries of the clavicle and
its articulation. J Bone Joint Surg Am. 1967;49(4):774–84. [PubMed:
2. Dias JJ, Gregg PJ. Acromioclavicular joint injuries in sport. Recommendations
for treatment. Sports Med. 1991;11(2):125–32. [PubMed:
3. Lemos MJ. The evaluation and treatment of the injured acromioclavicular
joint in athletes. Am J Sports Med. 1998;26(1):137–44. [PubMed:
4. Wolf EM, Pennington WT. Arthroscopic reconstruction for acromioclavicular
joint dislocation. Arthroscopy. 2001;17(5):558–63. doi:
10.1053/jars.2001.23578. [PubMed: 11337730].
5. Sim E, Schwarz N, Hocker K, Berzlanovich A. Repair of complete
acromioclavicular separations using the acromioclavicular-hook
plate. Clin Orthop Relat Res. 1995(314):134–42. [PubMed: 7634626].
6. El Sallakh SA. Evaluation of arthroscopic stabilization of acute
acromioclavicular joint dislocation using the TightRope system. Orthopedics.
2012;35(1):18–22. doi: 10.3928/01477447-20111122-13. [PubMed:
7. Metzlaff S, Rosslenbroich S, Forkel PH, Schliemann B, Arshad H,
Raschke M, et al. Surgical treatment of acute acromioclavicular
joint dislocations: hook plate versus minimally invasive reconstruction.
Knee Surg Sports Traumatol Arthrosc. 2016;24(6):1972–8. doi:
10.1007/s00167-014-3294-9. [PubMed: 25209209].
8. Constant CR, Murley AH. A clinical method of functional assessment
of the shoulder. Clin Orthop Relat Res. 1987(214):160–4. [PubMed:
9. Balke M , Schneider M M , Akoto R , Bathis H , Bouillon B , Banerjee M
. [Acute acromioclavicular joint injuries : Changes in diagnosis and
therapy over the last 10 years.]. Unfallchirurg. 2014;118(10):851–7.
10. Bajnar L, Bartos R, Sedivy P. [Arthroscopic stabilisation of acute
acromioclavicular dislocation using the TighRope device]. Acta Chir
Orthop Traumatol Cech. 2013;80(6):386–90. [PubMed: 24750965].
11. Stubig T, Jahnisch T, Reichelt A, Krettek C, Citak M, Meller R. Navigated
vs arthroscopic-guided drilling for reconstruction of acromioclavicular
joint injuries: accuracy and feasibility. Int J Med Robot.
2013;9(3):359–64. doi: 10.1002/rcs.1506. [PubMed: 23784857].