Arthroscopic Anatomical Acromioclavicular Joint Reconstruction using a Button Device and a Semitendinosus Graft |
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| Authors: | Carlos Maia Dias Maria Joo Leite Manuel Ribeiro da Silva Pedro Granate Jos Manuel Teixeira |
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| Institution: | 1. Hospital da Luz Lisboa, Lisbon Portugal ; 2. Unidade Cuidados Médicos de Acidentes Fidelidade Lisboa, Lisbon Portugal ; 3. Hospital CUF Santarém, Santarém Portugal ; 4. Centro Hospitalar Universitário São João, Porto Portugal ; 5. Hospital CUF Porto, Porto Portugal ; 6. Hospital da Luz Arrábida, Vila Nova de Gaia Portugal ; 7. Unidade Cuidados Médicos de Acidentes Fidelidade Porto, Porto Portugal |
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| Abstract: | ObjectiveTo report a new technique for anatomical acromioclavicular (AC) joint reconstruction.MethodsIn order to minimize such complications, the authors describe a new anatomical and biological AC joint repair. This technique aims to provide greater stability by using two anatomically placed clavicular tunnels and a combined construct with a double endobutton cortical fixation for primary stabilization, and to be biologically advantageous by using an autologous semitendinosus (ST) tendon graft. Additionally, the coracoclavicular ligament reconstruction is complemented with an AC joint cerclage and capsular reinforcement, which will protect the biological construction in its initial stage of healing.ResultsThis technique provides adequate primary and secondary biomechanical stability by passing both a semitendinosus autogenous graft and a double endobutton device, through anatomically placed and small diameter clavicle holes, without the need for coracoid drilling. Our technique showed encouraging results regarding pain resolution, range of motion, and function. At final follow‐up we experienced excellent results with average pain score of 1.6, and average ROM of 159° of forward flexion, 160° of abduction, 68° of external rotation, and internal rotation level at T11. Postoperative function also showed great improvements with average ASES of 85 points, an average Constant Score of 87 and a Subjective Shoulder Value of 89 points. This technique also achieved perfectly acceptable radiographic results, with an average coracoclavicular distance increase of 0.8 mm. Regarding complications, our sample showed one case of AC join subluxation, two cases of internal saphenous nerve injury, and two partial graft tears at the suture‐button interface, with none of these requiring surgical revision.ConclusionThis technique is advantageous in treatment of acromioclavicular joint dislocation and can be performed in both the subacute and chronic setting. |
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| Keywords: | Acromioclavicular joint dislocation Arthroscopic Coracoclavicular anatomical reconstruction |
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