Arthroscopically assisted anatomical coracoclavicular ligament reconstruction using tendon graft

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Anatomical Ligament Reconstruction

Background:

• Acromioclavicular (AC) joint dislocations, particularly high-grade injuries (Grade III or V), often require surgical intervention.
• Traditional methods may involve significant disruption of anatomy, potentially compromising stability and function.
• Restoring the native coracoclavicular ligament (CCL) anatomy is crucial for optimal shoulder stability.

Purpose of the Study:

• To describe a novel arthroscopically assisted, mini-open anatomical reconstruction technique for the coracoclavicular ligament.
• To restore both the conoid and trapezoid components of the native CCL.
• To achieve maximum shoulder stability with minimal disruption of surrounding anatomy.

Main Methods:

• Anatomical reconstruction of the coracoclavicular ligament using transosseous tunnels mirroring native conoid and trapezoid footprints.
• Utilizing an autologous graft secured with a PEEK screw for fixation.
• Employing arthroscopically assisted, mini-open surgical approach.

Main Results:

• The described technique facilitates adequate ligament healing within bone tunnels, preventing stress risers.
• The procedure successfully restores both components of the native CCL.
• Initial clinical outcomes from 13 patients showed excellent satisfaction with a mean Constant score of 96.6.

Conclusions:

• This minimally invasive anatomical reconstruction technique effectively restores coracoclavicular ligament integrity.
• The procedure is suitable for treating acute acromioclavicular dislocations Grades III and V.
• The technique offers a natural substitute for the torn ligament in its anatomical location, leading to high patient satisfaction.