Arthroscopically Assisted Stabilization of Chronic Acromioclavicular Joint Instability

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomedical Engineering

Background:

• Chronic acromioclavicular (AC) joint injuries often require surgical stabilization.
• Existing techniques may involve multiple bone tunnels, potentially weakening osseous structures.
• Minimizing soft tissue irritation from implants is crucial for patient comfort.

Purpose of the Study:

• To demonstrate a modified biological and synthetic AC and coracoclavicular stabilization technique.
• To highlight the use of a hamstring tendon graft and a low-profile TightRope implant.
• To present a method that avoids weakening osseous structures through optimized graft passage.

Main Methods:

• Arthroscopic preparation of the coracoid base and transtendinous portals.
• Transcoracoidal-transclavicular drilling for TightRope placement.
• Graft passage around the clavicle and coracoid using nitinol suture passing wires.
• AC cerclage via transacromial drilling and graft shuttling.
• Tensioning and securing of the graft with fascial closure.

Main Results:

• The low-profile TightRope implant reduces soft-tissue irritation.
• The modified technique utilizes fewer tunnels, preserving bone integrity.
• Similar biomechanical principles to existing successful techniques suggest comparable outcomes.

Conclusions:

• This modified technique offers a potentially safer and more effective approach to AC and coracoclavicular stabilization.
• Optimized graft passage minimizes risks associated with traditional methods.
• Future research will focus on specific clinical and radiographic outcomes.