An Arthroscopic-assisted AC Joint Reconstruction and Hook Plate Fixation for the Treatment of AC Joint Dislocation: A Unique Surgical Technique

Acromioclavicular Joint (ACJ) dislocations can lead to increased pain and disability. On failure of conservative management, surgical intervention is often recommended. At present, there is no gold standard surgical technique to treat this pathology. The current surgical options include coracoclavicular screw, hook plate (HP), endobutton coracoclavicular fixation, ligament reconstruction, and among others. Unfortunately, all these techniques have been reported to have increased complications such as recurrent dislocation, impingement, and among others.

A 41-year-old healthy male presented to the clinic with a symptomatic chronic right Grade 3 ACJ dislocation. He failed conservative treatment, including NSAID's, rest, and physical therapy. We agreed to pursue an arthroscopic assisted ACJ reconstruction with allograft and joint fixation with a HP. Using a combined technique, we performed an arthroscopic-assisted ACJ reconstruction with an allograft and supplemental HP for additional fixation. This case report details the unique technique. Using this technique, the patient had improved pain and ACJ stability long-term. After 6 months, the HP was removed and the patient continued to remain asymptomatic and without instability.

An arthroscopic-assisted ACJ reconstruction and HP fixation provide orthopedic surgeons a novel technique for the treatment of an ACJ dislocation. Further prospective studies are still recommended for further evaluation.