Arthroscopic Reconstruction After Acute Acromioclavicular Separation Injuries

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Shoulder Joint Anatomy

Background:

• Acute acromioclavicular (AC) joint dislocations are common shoulder girdle injuries.
• High-grade AC joint injuries (Rockwood types IV-VI) typically require surgical repair.
• Treatment for type III AC joint injuries remains debated, though surgical stabilization may benefit young, active patients.

Purpose of the Study:

• To describe and evaluate an arthroscopically assisted double-button technique with AC cerclage for acute AC joint stabilization.
• To highlight the minimally invasive nature and potential benefits of arthroscopic AC joint reconstruction.

Main Methods:

• The procedure involves arthroscopic visualization and image-intensifier control for precise drilling and implant placement.
• Key steps include creating viewing and working portals, dissecting the coracoid base, drilling coracoclavicular tunnels, and placing double-button devices.
• An AC cerclage tape is added for horizontal stabilization, followed by layered closure.

Main Results:

• The described technique allows for anatomical reduction of the AC joint.
• The procedure is reported as safe and yields good to excellent clinical results.
• Arthroscopic techniques are increasingly favored due to their minimally invasive nature and ability to address concomitant injuries.

Conclusions:

• The combined arthroscopically-assisted double-button technique with AC cerclage is a safe and effective method for stabilizing acute AC joint dislocations.
• This approach facilitates anatomical reduction and achieves favorable clinical outcomes.
• Early surgical intervention within 3 weeks of injury is recommended to maximize biological healing potential.