Coracoclavicular ligament reconstruction for acromioclavicular dislocation using 2 suture anchors and coracoacromial ligament transfer

Abstract

Background: The ideal surgical treatment for complete acromioclavicular dislocation is considered to be restoring separately each ligament supporting the joint to achieve optimal clinical outcomes. Hypothesis: Reconstruction of the coracoclavicular ligaments using 2 suture anchors and coracoacromial ligament transfer in patients with acromioclavicular dislocation provides reliable clinical outcomes. Study Design: Case series; Level of evidence, 4. Methods: Twenty-nine patients with acute acromioclavicular dislocation were treated using the devised technique. All patients had type V acromioclavicular dislocation and underwent surgery within 3 weeks of injury. Two 3.5-mm suture anchors with doubly loaded sutures were separately inserted into the anterolateral and posteromedial portions of the coracoid process, the coracoid insertions of the trapezoid, and conoid ligaments. For each suture anchor, 2 clavicular holes were made above the anchor through which the suture strands were passed, and the strands were tied over the clavicle. The coracoacromial ligament was then transferred to the undersurface of the distal end of the clavicle. Results: After a mean follow-up of 28 months, mean Constant score improved to 97 points. All 29 patients returned to normal life at a mean of 3 months postoperatively. According to radiologic findings, 24 patients achieved anatomical reduction of the acromioclavicular joint. In 2 patients, the mean vertical coracoclavicular distance difference between both shoulders was 50% to 100%. Three patients showed reduction loss of more than 100% within 3 weeks after the operation. Conclusion: Coracoclavicular ligament reconstruction using 2 suture anchors and coracoacromial ligament transfer in complete acromioclavicular dislocation is a reliable technique for restoring stability to the acromioclavicular joint. © 2009 American Orthopaedic Society for Sports Medicine.