Acromioclavicular joint reconstruction with coracoacromial ligament transfer using the docking technique

Area of Science:

• Orthopedic surgery
• Sports medicine
• Anatomy

Background:

• Symptomatic Acromioclavicular (AC) dislocations often require surgical intervention.
• Traditional treatments involve Coracoclavicular (CC) ligament reconstruction using the Coracoacromial (CA) ligament.
• Successful outcomes depend on proper CA ligament tensioning.

Purpose of the Study:

• To evaluate a modified 'docking' technique for CC ligament reconstruction in AC joint injuries.
• To assess the efficacy of tensioning the CA ligament within an intramedullary bone tunnel.
• To determine the clinical and radiographic outcomes of this surgical procedure.

Main Methods:

• Seventeen patients with chronic Type III or acute Type IV/V AC joint injuries underwent surgery.
• The procedure involved distal clavicle resection and CC ligament reconstruction using the CA ligament.
• A modified 'docking' technique was employed to pass and tension the CA ligament into the medullary canal.

Main Results:

• Significant improvement in postoperative American Shoulder and Elbow Surgeons (ASES) scores and pain levels (p = 0.001).
• High radiographic success rate, with 94% of patients maintaining reduction.
• Only one patient experienced recurrent dislocation, with an excellent ultimate outcome.

Conclusions:

• The modified 'docking' procedure facilitates effective tensioning and intramedullary healing of the transferred CA ligament.
• This technique significantly improves clinical results and reduces the risk of recurrent distal clavicle instability.
• The study highlights a reliable surgical option for managing complex AC joint dislocations.