, Volume 102, Issue 1, pp 73–79 | Cite as

A comparison between two double-button endoscopically assisted surgical techniques for the treatment acute acromioclavicular dislocations

  • P. Vulliet
  • M. Le Hanneur
  • V. Cladiere
  • P. Loriaut
  • P. Boyer
Original Article



To compare clinical and radiological outcomes between two endoscopically assisted double-button techniques in high-grade acute acromioclavicular separations.


A retrospective single-center study was conducted in patients with acute acromioclavicular joint dislocation Rockwood types III and V, from 2009 to 2014. All were treated endoscopically, with a 1-year minimum follow-up. Two consecutive series were conducted; the first (TR group) received the TightRope® system, whereas last series (DB group) was treated with the Dog Bone® button technology (Arthrex, Naples, FL, USA). Primary endpoints were last follow-up values of Constant score (CS) and Quick-DASH (QD) score. Moreover, the posttraumatic displacement and its evolution were assessed on bilateral Zanca radiographs. A displacement of 5 mm or greater the day after surgery was considered as a lack of reduction; the same difference on last follow-up X-rays was considered as a loss of reduction.


Forty patients were reviewed: 22 in the TR group and 18 in the DB group. After a mean follow-up of 27.7 ± 8.3 months, CS and QD averaged, respectively, 94.3 ± 4.4 and 2.0 ± 2.6 in the TR series, whereas they averaged, respectively, 95 ± 6.1 and 3.4 ± 3.3 in the DB series after a mean follow-up of 24.1 ± 5 months (PCS = 0.16, PQDS = 0.08). Lack of reduction and loss of reduction rates were significantly higher in the DB group, with P = 0.0005 and P < 0.0001, respectively.


Both techniques provided good to excellent functional outcomes. However, considering inferior radiological results using the Dog Bone® device, we would prefer the TightRope® device in acute acromioclavicular dislocations.

Level of evidence

IV: Therapeutic study—cases series.


Acromioclavicular instability Arthroscopic stabilization Button TightRope Dog Bone 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interests. None of them has a financial interest in any of the products, devices or drugs mentioned in this manuscript. They have not received or will receive any financial aid, in any form, for this study, from any of the following organizations: National Institutes of Health (NIH); Wellcome Trust; Howard Hughes Medical Institute (HHMI); or other(s).


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Copyright information

© Istituto Ortopedico Rizzoli 2017

Authors and Affiliations

  1. 1.Department of Orthopedics and Traumatology – Service of Hand, Upper Limb and Peripheral Nerve Surgery - Assistance Publique – Hôpitaux de Paris, Georges Pompidou European Hospital (HEGP)Paris Descartes UniversityParisFrance
  2. 2.Department of Orthopedic Surgery, Assistance Publique – Hôpitaux de Paris, Bichat – Claude Bernard HospitalParis Diderot UniversityParisFrance
  3. 3.Clinique des LilasLes LilasFrance

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