RÉSUMÉ
<p><b>OBJECTIVE</b>To study the clinical outcome and complications of Tightrope button plate for repairing acromioclavicular dislocation of Rockwood type III to V.</p><p><b>METHODS</b>From May 2014 to December 2016, 17 patients with acromioclavicular dislocation of type III-V were treated with Tightrope button plate including 10 males and 7 females with an average age 39.8 years old ranging from 20 to 68 years old. Four patients were treated with arthroscopy and 17 patients were treated with mini-invasive by X-ray assisted. Shoulder function, X-ray and complications after operation were assessed.</p><p><b>RESULTS</b>All patients were followed up for 5 to 23 months with a mean of 10.8 months. All patients got satisfying reduction immediately postoperatively. Among them, 1 case of clavicle end wound foreign body reaction, rupture, effusion, healing after the second suture; 1 case of foreign body granuloma formation at the end of clavicle were resected and removed at 4 months after operation; 3 cases loss reduction(less than 50% of acromioclavicular joint). No coracoid fracture and suture breakage observed. The shoulder mobility was restored in 15 cases at 4 to 6 weeks postoperatively, and the shoulder adhesion in 2 cases was delayed to 5 to 7 months after operation. The Constant scores were improved from 46.9±6.0 preoperatively to 92.7±4.0 at the final follow-up. X-ray evaluation of postoperative coracoclavicular tunnel location, patients' coracoclavicular tunnel with mini-invasive fluoroscopy all closed to the ideal position (across the clavicle vertically through the coracoid base center), while different degree of tunnel position deviation were observed in arthroscopic patients.</p><p><b>CONCLUSIONS</b>Tightrope button plate for the treatment of acromioclavicular joint dislocation had advantages of minimally invasive, effective, good clinical results, the majority of common complications does not affect efficacy. Small incision X-ray method can provide more satisfactory and reliable tunnel location.</p>
RÉSUMÉ
<p><b>OBJECTIVE</b>To explore the operating procedures and therapeutic effects of medial patellofemoral ligament reconstruction with Tightrope(Arthrex, FL, USA) button fixation at lateral femoral cortex.</p><p><b>METHODS</b>From May 2014 to July 2016, 9 patients with traumatic patellar dislocation were treated. There were 5 males and 4 females, ranging in age from 16 to 47 years old, with an average of 23.7 years old. All the patients underment arthroscopic lateral retinaculum release and joint debridement first. Then the medial patellofemoral ligament was reconstructed by using a semitendinosus autograft. The ends of semitendinosus were pulled into two patellar tunnels respectively, knotted and fixed at the lateral side of patella. The semitendinosus loops were suspended and fixed through femoral tunnel with Tightrope button. The knee was fixed to about 60 degree and the tension of MPFL was adjusted by pulling Tightrope wire under arthroscopic observation. Two patients received superomedial transfer of tibial tuberosity on account of TT-TG >=20 mm.</p><p><b>RESULTS</b>All the patients were followed up, and the duration ranged from 6 to 23 months, with an average of 13.6 months. Patellar stability was re-obtained in all patients. No dislocation re-currenced during the follow-up period. The Kujala score(scoring of patellofemoral disorders) was improved at the latest follow-up compared with that before operation. All the patients returned to routine life.</p><p><b>CONCLUSIONS</b>Reconstruction of medial patellofemoral ligament with the Tightrope button fixation on the femoral side for the treatment of traumatic patellar dislocation is effective and economic. The method make the MPFL tension adjustable during the reconstuction under arthroscopy. The MPFL tension should be adjusted at 60 degree flexion of knee in order to avoid making tension level too high.</p>