The low-profile loop titanium plate system for acromioclavicular joint dislocation: A retrospective cohort study on learning curve and clinical efficacy.
Liang Zhang, Jin Zhang, Longhui Shao, Jing Li, Chunling Song, Juan Bai, Lei Wang
Abstract
Open AccessThis study aimed to evaluate the clinical efficacy of LP-LTPS for treating Rockwood type IIIB ACJ dislocation, while analyzing the learning curve and CUSUM curve of the new technique. A retrospective analysis was conducted on 179 patients with Rockwood type IIIB ACJ dislocation (82 in the LP-LTPS group and 97 in the hook-plate control group) between April 2020 and May 2022. Learning curve and CUSUM curve analyses were performed using operation time data from the LP-LTPS group, with the first 5 cases excluded as the learning phase. Clinical outcomes included Constant-Murley Score and visual analogue scale, operation time, incision length, blood loss, complications, and radiographic parameters. Statistical comparisons used independent t-tests for continuous variables and chi-square tests for categorical variables (P <.05). The learning curve showed surgical proficiency was achieved after 5 cases, with stable operation time (38.88 ± 5.42 minutes). The LP-LTPS group demonstrated significantly shorter incision length, reduced blood loss, and lower complication rate versus the control group (all P <.05). Postoperative Constant-Murley Score was higher in the LP-LTPS group at all time points (P <.05). For visual analogue scale, the LP-LTPS group had significantly lower pain scores at 2 days, 1 month, and 3 months postoperatively (P <.001), with no significant differences at 6 and18 months (P >.05). Preoperative AC/CC distances were comparable between groups (P >.05). At 12 months postoperatively, both groups showed significant reductions in AC/CC distances versus baseline (P <.001), with no significant between-group differences (P >.05). LP-LTPS offers superior clinical outcomes with a short learning curve, fewer complications, better functional recovery, and early pain control compared to control group for Rockwood type IIIB ACJ dislocation, supporting its use as an effective alternative.