Short-term outcomes of arthroscopic TightRope® fixation are better than hook plate fixation in acute unstable acromioclavicular joint dislocations

  • Hamid Rahmatullah Bin Abd RazakEmail author
  • Eng-Meng Nicholas Yeo
  • William Yeo
  • Tijauw-Tjoen Denny Lie



The aim of this study was to compare the short-term outcomes of arthroscopic TightRope® fixation with that of hook plate fixation in patients with acute unstable acromioclavicular joint dislocations.

Patients and methods

We conducted a prospective case–control study of twenty-six patients with an acute ACJ dislocation who underwent surgical repair with either an arthroscopic TightRope® fixation or a hook plate from 2013 to 2016. Clinical and radiological data were collected prospectively. Clinical outcomes were evaluated using the Constant Score, the University of California at Los Angeles (UCLA) Shoulder Score, Oxford Shoulder Score as well as the visual analogue scale. Radiological outcomes were assessed with the coracoclavicular distance (CCD).


Sixteen patients underwent arthroscopic TightRope® fixation, while 10 patients underwent hook plate fixation. There were no significant differences in the preoperative variables except for the mean UCLA 4b infraspinatus score (TightRope® 2.8 vs. hook plate 3.8; p = 0.030). Duration of surgery was significantly longer in the TightRope® group. At 1 year post-operatively, the TightRope® group had a significantly better Constant Score and CCD with no complications. All patients with hook plate fixation had to undergo a second procedure for removal of implant, and 3 patients had complications.


Arthroscopic TightRope® fixation is a good option for the treatment of acute unstable ACJ dislocations. It has better short-term clinical and radiological outcomes as well as lesser complications when compared to hook plate fixation.

Level of evidence

Therapeutic, Level III.


TightRope® Hook plate Acromioclavicular ACJ Outcomes Complications 


Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2017

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgerySingapore General HospitalSingaporeSingapore
  2. 2.Orthopaedic Diagnostic CentreSingapore General HospitalSingaporeSingapore

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