An Innovative Approach to Chronic and Neglected Acromioclavicular Joint Dislocation: A Cost-Effective and Reliable Solution

Acromioclavicular (AC) joint dislocation accounts for a substantial proportion of shoulder injuries, and chronic or neglected cases - where the coracoclavicular (CC) ligaments have lost healing potential - pose particular management challenges. Numerous surgical techniques exist, but many are limited by graft weakness, hardware complications, or cost. This study presents a technique for chronic AC joint reconstruction using synthetic tape combined with lateral clavicle excision.

In this retrospective study, 11 patients with delayed presentation (≥6 weeks post-injury) and Rockwood grade 3-5 AC joint dislocation underwent surgery using a 30 cm × 5 mm Mersilene tape to reconstruct the CC ligaments, without fixation hardware or grafts, combined with lateral clavicle excision. Patients were assessed pre- and post-operatively using the AC joint instability (ACJI) score, visual analog scale (VAS) pain score, and Constant-Murley score, with follow-up to 2 years.

Mean patient age was 46.6 years, with a male-to-female ratio of 3:1. The mean ACJI score improved from 63.7 pre-operatively to 81.4 at 2 years. VAS pain score improved from 6.41 pre-operatively to 2.68 at 6 months and 1.25 at 12 months. Constant-Murley score improved from 51 to 92.08 at 12 months. One patient had a 20% vertical clavicle displacement without clinical complaints; all other patients achieved stable, satisfactory outcomes in pain, cosmesis, and shoulder function.

Unlike techniques reliant on graft healing or hardware fixation - which carry risks of graft weakening, stress fracture, or implant-related complications - this Mersilene tape technique avoids implant removal and provides durable mechanical support for CC ligament reconstruction. It offers a cost-effective alternative to imported graft materials while achieving comparable or superior functional outcomes.

This synthetic tape-based technique for chronic AC joint reconstruction is rapid, reproducible, and cost-effective, providing durable and predictable clinical outcomes with low morbidity.