Abstract
OBJECTIVE: This study aims to compare the clinical and radiographic outcomes of the tight-rope system versus internal fixation with a hook plate for treating grade III-VI acute acromioclavicular dislocation. METHODS: Relevant studies were identified by searching PubMed, Cochrane, and Google Scholar, from January 2017 to December 2023. The primary focus of the study revolved around evaluating various factors such as the Constant Score, University of California Los Angeles (UCLA) Shoulder Score, Visual Analogue Scale (VAS), coracoclavicular distance (CCD), and incidences of complications. The analysis involved determining the weighted mean difference (WMD) along with its corresponding 95 % confidence intervals (95 % CIs), or risk ratios (RR) with 95 % CIs to quantify the collected data. RESULTS: Eight studies comprising 484 participants were included. Significant differences were observed in the Constant-Murley score between groups. However, no disparities were found in UCLA scores, VAS scores, or CCD improvement. Subgroup analyses also yielded consistent results. CONCLUSIONS: Both treatment modalities demonstrated similar clinical and radiographic efficacy in alleviating pain, enhancing acromioclavicular joint function, and correcting coracoclavicular distance. Nevertheless, the TightRope system exhibited additional advantages, including reduced reoperation rates and lower risk of subacromial distal clavicle osteolysis.