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Primary Acromioclavicular-Coracoclavicular Reconstruction Using 2 Allografts, TightRope, and Stabilization to the
Daniel B Haber1, Petar Golijanin2, Genevra L Stone3
1Harvard Combined Orthopaedic Residency Program, Massachusetts General Hospital, Boston, Massachusetts, U.S.A.
Arthroscopy Techniques
|March 23, 2019
Summary
Acromioclavicular (AC) joint injuries are common in athletes. This technical note details a surgical technique using tendon grafts and a cortical button for AC joint instability, aiming for superior ligament reconstruction.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Biomechanics
Background:
- Acromioclavicular (AC) joint injuries are prevalent, especially in young athletes involved in contact sports.
- These injuries result from direct impact and are graded I-VI, with higher grades often requiring surgical intervention.
- Current surgical techniques lack a definitive gold standard, despite biomechanical evidence favoring anatomic ligament reconstruction.
Purpose of the Study:
- To describe a preferred surgical technique for primary treatment of AC joint instability.
- To address both acute and chronic AC joint injuries.
- To present a novel approach combining biologic reconstruction with a strong suspensory device.
Main Methods:
- The technique utilizes two free tendon grafts for anatomic reconstruction of the AC and coracoclavicular ligaments.
- A cortical button suspensory device is employed to provide immediate stability.
- This approach aims to combine the benefits of nonrigid biologic reconstruction with the strength of a rigid fixation device.
Main Results:
- The described technique offers a method for anatomic AC and coracoclavicular ligament reconstruction.
- It combines a nonrigid biologic component with the mechanical strength of a cortical button.
- This approach is designed to resist displacement of the AC joint effectively.
Conclusions:
- This technical note presents a viable surgical option for AC joint instability.
- The described method integrates biologic graft healing with mechanical support for robust reconstruction.
- The technique aims to provide a superior surgical construct for AC joint injuries.
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