Modified technique for anatomic acromioclavicular joint reconstruction

Abstract

Introduction: Acromioclavicular (AC) joint reconstruction using a tendon graft with clavicular tunnels and with/without coracoid tunnels is a treatment of choice for injuries more severe than Grade III. We are reporting a modified technique of AC joint reconstruction using tendon graft and endobutton loop in nine patients at mean follow-up of 18 months. Materials and Methods: Nine patients with an average age of 36 years (25-55 years) underwent this procedure between October 2011 and June 2013 at this hospital for Grade III or more AC joint injury. In all the patients, the semitendinosus graft was used to recreate coracoclavicular and AC ligaments with the added fixation with fiberwire tied over an endobutton over the clavicle. Results : At the mean follow-up of 18 months the average American Shoulder and Elbow Surgeons score was 89.06 (Range 69.99-96.66) and constant score was 89.77 (Range 75-97). According to constant score four patients had excellent, four had good, and one had satisfactory post-operative function according to constant score. One patient had minimal (0.5 cm) loss of reduction and one had a superficial infection. Both this complication did not affect the final outcome. Conclusion: This technique is near anatomic with added advantage of protecting the repair with fiber wire suture and also reducing the risk of clavicular fracture with endobuttion placed on the superior surface of clavicle. It also avoids the risk of coracoid fracture.