No difference in clinical outcome at two-year follow-up in patients with acromioclavicular joint dislocation type III and V treated with hook plate or physiotherapy: a randomized controlled trial

Abstract Background: Postoperative shoulder pain was a most common complication after clavicular hook plate treatment for acromioclavicular joint dislocation. However, the researches on its risk factors were rare. The purpose of this study was to evaluate the incidences of postoperative shoulder pain of acromioclavicular joint dislocation treat with hook plate and to identify risk factors in patients with an acute acromioclavicular joint dislocation. Method: We retrospectively analyzed the prospectively collected data from 310 consecutive patients with AC joint dislocation between December 2014 and August 2019 at our institute. Patients rated the average intensity of shoulder pain using an 11-point numerical rating scale (NRS). The dependent variable was the presence of moderate-to-severe neck pain (NRS ≥4) at the last follow-up when the internal fixation will be removed. The independent variables included age, gender, body-mass index (BMI), smoking status, alcohol consumption, type of injury, Rockwood Classification, site of injury, operation time, injury-to-surgery, DHA, DH and AHP. Logistic regression analysis was performed to identify independent risk factors of moderate-to-severe shoulder pain of acromioclavicular joint dislocation treat with hook plate. Results: A total of 292 patients were included in the study and 18 cases were lost to follow-up. The follow-up rate was 94.1%. In all cases, there were 166 male cases and 126 female cases. Of these cases, the NRS < 4 group had 219 patients. Among them, there were 120 males and 99 females. 12 patients were lost to follow-up. There were 73 patients in NRS ≥ 4 group, 46 males and 27 females. 6 cases were lost to follow-up. The number of patient in NRS ≥ 4 group accounted for about 25.0% of the total cases. DH was the significant independent risk factor for postoperative shoulder pain of acromioclavicular joint dislocation treat with hook plate. DHA and AHP were also independent factors of postoperative shoulder pain, but they were all protective. Conclusions: DH was the significant independent risk factor for postoperative shoulder pain of acromioclavicular joint dislocation treat with hook plate. DHA and AHP were also independent factors of postoperative shoulder pain, but they were all protective. We should try to refer to these factors to avoid postoperative shoulder pain when performing clinical operations.

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Clinical Outcome in All-Arthroscopic Versus Mini-Open Rotator Cuff Repair in Small to Medium-Sized Tears: A Randomized Controlled Trial in 100 Patients With 1-Year Follow-up

Arthroscopy The Journal of Arthroscopic and Related Surgery ◽

10.1016/j.arthro.2012.08.022 ◽

2013 ◽

Vol 29 (2) ◽

pp. 266-273 ◽

Cited By ~ 62

Author(s):

Peer van der Zwaal ◽

Bregje J.W. Thomassen ◽

Marc J. Nieuwenhuijse ◽

Ruud Lindenburg ◽

Jan-Willem A. Swen ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Rotator Cuff ◽

Clinical Outcome ◽

Rotator Cuff Repair ◽

Controlled Trial ◽

Randomized Controlled ◽

Cuff Repair ◽

Mini Open

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The Hydrogel Endovascular Aneurysm Treatment Trial (HEAT): A Randomized Controlled Trial of the Second-Generation Hydrogel Coil

Neurosurgery ◽

10.1093/neuros/nyaa006 ◽

2020 ◽

Vol 86 (5) ◽

pp. 615-624 ◽

Cited By ~ 5

Author(s):

Bernard R Bendok ◽

Karl R Abi-Aad ◽

Jennifer D Ward ◽

Jason F Kniss ◽

Mary J Kwasny ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Clinical Outcome ◽

Packing Density ◽

Intracranial Aneurysms ◽

Second Generation ◽

Controlled Trial ◽

Treatment Trial ◽

Randomized Controlled ◽

Secondary Endpoints

Abstract BACKGROUND Aneurysm recurrence after coiling has been associated with aneurysm growth, (re)hemorrhage, and a greater need for follow-up. The second-generation HydroCoil Embolic System (HES; MicroVention, Inc) consists of a platinum core with integrated hydrogel and was developed to reduce recurrence through enhancing packing density and healing within the aneurysm. OBJECTIVE To compare recurrence between the second-generation HES and bare platinum coil (BPC) in the new-generation Hydrogel Endovascular Aneurysm Treatment Trial (HEAT). METHODS HEAT is a randomized, controlled trial that enrolled subjects with ruptured or unruptured 3- to 14-mm intracranial aneurysms amenable to coiling. The primary endpoint was aneurysm recurrence using the Raymond-Roy scale. Secondary endpoints included minor and major recurrence, packing density, adverse events related to the procedure and/or device, mortality, initial complete occlusion, aneurysm retreatment, hemorrhage from target aneurysm during follow-up, aneurysm occlusion stability, and clinical outcome at final follow-up. RESULTS A total of 600 patients were randomized (HES, n = 297 and BPC, n = 303), including 28% with ruptured aneurysms. Recurrence occurred in 11 (4.4%) subjects in the HES arm and 44 (15.4%) subjects in the BPC arm (P = .002). While the initial occlusion rate was higher with BPC, the packing density and both major and minor recurrence rates were in favor of HES. Secondary endpoints including adverse events, retreatment, hemorrhage, mortality, and clinical outcome did not differ between arms. CONCLUSION Coiling of small-to-medium aneurysms with second-generation HES resulted in less recurrence when compared to BPC, without increased harm. These data further support the use of the second-generation HES for the embolization of intracranial aneurysms. Video Abstract

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Complete acromioclavicular joint dislocation treated with reconstructed ligament by trapezius muscle fascia and observation of fascial metaplasia

Open Medicine ◽

10.1515/med-2015-0055 ◽

2015 ◽

Vol 10 (1) ◽

Author(s):

Chaoliang Wang ◽

Sufang Huang ◽

Yingzhen Wang ◽

Xuesheng Sun ◽

Tao Zhu ◽

...

Keyword(s):

Acromioclavicular Joint ◽

Constant Score ◽

Vertical Plane ◽

Trapezius Muscle ◽

Hook Plate ◽

Acromioclavicular Joint Dislocation ◽

Coracoclavicular Ligament ◽

Joint Dislocation ◽

Muscle Fascia

AbstractWe evaluated the long-term clinical results of acute complete acromioclavicular dislocations treated by reconstruction of the acromioclavicular and coracoclavicular ligament using trapezius muscle fascia. Open reduction and internal fixation was performed using the clavicular hook plate in 12 patients with acute complete acromioclavicular joint dislocation, and the acromioclavicular and coracoclavicular ligaments were reconstructed using trapezius muscle fascia. Radiographic evaluations were conducted postoperatively. We evaluated the functional results with constant scoring system and radiological results at the final follow-up visit. The mean Constant score at the final follow-up visit was 91.67 (range, 81 to 100). The results were excellent in eight patients (66.7%) and good in four patients (33.3%). Three patients with scores from 80 to 90 had mild pain during activity, but this did not affect the range of motion of the shoulder. All patients have returned to their preoperative work without any limitations. Compared with the contralateral side, radiography showed anatomical reposition in the vertical plane in all cases. The hook-plate fixation with ligament reconstruction was successful in treating AC dislocations. The acromioclavicular and coracoclavicular ligament were reconstructed by trapezius muscle fascia that keep the distal clavicle stable both vertically and horizontally after type III injuries.

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The influence of different hook tip depths on the treatment of acromioclavicular joint dislocation with clavicular hook plate – a retrospective study

10.21203/rs.2.20880/v1 ◽

2020 ◽

Author(s):

ding xu ◽

Peng Luo ◽

Yulong Shi ◽

Weikang Wang ◽

Weijun Guo ◽

...

Keyword(s):

Acromioclavicular Joint ◽

Functional Results ◽

Hook Plate ◽

Acromioclavicular Joint Dislocation ◽

Joint Dislocation ◽

Clavicular Hook Plate ◽

Group A ◽

Joint Reduction ◽

Group B

Abstract Background The purpose of this study was to research the effect of different hook depths on the efficacy and complications of AC dislocation treatment with hook plate, and to provide valuable reference for clinical treatment.Method We retrospectively analyzed the prospectively collected data from 305 consecutive patients with AC joint dislocation between April 2013 and May 2017 at our institute. We defined〝hook tip depth〞as the position of the hook tip relative to the acromion at the coronal plane. According to the division where the tip of the hook was located, the cases were divided into Group A, Group B, Group C, and D group. All patients were required to conform to regular follow up postoperatively. Dislocation and implant maintenance are assessed by routine shoulder imaging. Functional results were evaluated using Constant-Murley criteria.Results A total of 305 cases were included in follow-up and 27 cases were lost. We used Constant-Murley criteria to evaluate functional results. The score of Group B was significantly higher than group A and group C (P<0.01). For evaluation of acromioclavicular joint reduction, we used CCD in imaging to evaluate. There was significant difference between the three groups. Joint reduction was obtained in all patients. Postoperative infection and hardware failure did not present. There were no fractures of acromion and coracoids process. There were 83 cases of shoulder pain, 93 cases of SIS and 124 cases of subacromial erosion. The incidence of complications in group A was significantly higher than group B and group C.Conclusions The relative position of the hook tip and acromion can significantly affect the efficacy and complications of the clavicular hook plate in the treatment of acromioclavicular joint dislocation. During surgery, we should control the depth of hook tip and try our best to put the tip of the hook into the area of group B to achieve an ideal postoperative effect and avoid the occurrence of various complications.

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