Editorial Commentary: Coracoclavicular Joint Reconstruction for Acromioclavicular Dislocation: Double-Bundle Techniques Are Anatomically and Biomechanically Favored |
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| Institution: | 1. Rush Medical College of Rush University;2. Editorial Board;1. American Hip Institute Research Foundation, Chicago, Illinois, U.S.A;2. American Hip Institute, Chicago, Illinois, U.S.A.;1. Hospital Italiano de Buenos Aires, Buenos Aires, Argentina;2. Oregon Shoulder Institute, Medford, Oregon, U.S.A.;1. Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea;2. Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University Hospital, Seoul, Republic of Korea;3. College of Medicine, Kyung Hee University, Seoul, Republic of Korea;4. Department of Orthopedic Surgery, Cheil Orthopedic Hospital, Seoul, Republic of Korea;1. Department of Orthopaedics and Rehabilitation, Larner College of Medicine, University of Vermont, Burlington, Vermont, U.S.A.;2. Centers for Advanced Orthopaedics, Washington, DC, U.S.A. |
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| Abstract: | For coracoclavicular (CC) joint reconstruction in the setting of acute acromioclavicular (AC) joint Rockwood type III or V dislocations, flexible fixation shows better clinical outcomes and complication rates than rigid fixation. Single-bundle CC reconstruction reconstructs the conoid ligament but poorly controls anteroposterior stability and is nonanatomic in nature. Thus, we favor double-bundle CC reconstruction incorporating a trapezoid bundle, replicating the broad insertion of the CC ligaments. Biomechanical data confirm improved stability with double-bundle, flexible fixation reconstruction, especially with the lateral clavicular tunnel in a more posterolateral location. An early clinical outcome study supports the double-bundle approach; meticulous surgical technique is required to avoid double-trouble complication rates. |
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