Post-traumatic acromioclavicular instability reconstruction with coracoacromial ligament and conjoined tendon: A preliminary report

BackgroundMany surgical techniques have been proposed to treat acromioclavicular (AC) injuries; however, anatomic coracoclavicular (CC) reconstructions with local tissue grafts have not been reported in previous studies. The aim of this study was to investigate early outcomes of this innovative technique.MethodsBetween 2004 and 2011, 15 patients with post-traumatic AC instability underwent anatomic reconstructions by two surgeons at our institution. Nine patients were treated with local tissue grafts, and these included six patients who underwent double-bundle reconstructions and three who underwent single-bundle reconstructions. The remaining six patients were treated with free tendon grafts. The clinical outcomes of the Constant scores and the radiographic results of the CC distance were further analyzed.ResultsIn patients who underwent reconstructions with local tissue grafts, those treated with double-bundle and selective-bundle reconstructions had an average postoperative Constant score of 89.0 ± 11.5 and 71.7 ± 38.4, respectively. In patients who underwent reconstructions with free tendon grafts, the average score was 73.0 ± 29.4. There was no statistically significant difference among the three reconstruction procedures. Only one patient showed residual AC separation on plain-film radiography.ConclusionThis innovative technique provided clinical and radiographic results that were comparable to those achieved with free tendon grafts. This procedure can be an alternative surgical option for treating AC joint instability.