Surgical treatment of high-grade acromioclavicular (AC) joint separations has become analogous to ligament reconstructions
elsewhere in the body with the goal being restoration of the native anatomy. Circumferential access to the base of the coracoid
is essential to reconstruct the coracoclavicular ligament complex. Using some of the traditional open approaches, this access
requires detaching the deltoid insertion and performing extensive soft tissue dissection. Also, poor visualization risks injury
to nearby neurovascular structures. An arthroscopically assisted reconstruction offers the advantage of less soft tissue dissection
and superior visualization to the base of the coracoid. We have developed a unique arthroscopically assisted technique that
uses a subacromial approach to pass suture material and a tendon graft around the coracoid to reconstruct the coracoclavicular
ligament complex. We describe our technique and preliminary results in 10 patients who have undergone coracoclavicular ligament
reconstruction for high-grade AC separation. All patients improved subjectively with regard to pain and function at a minimum
followup of 3 months (mean, 5 months; range, 3–18 months). This arthroscopically assisted technique has the potential to allow
for safe and at least in the short term reliable restoration of the coracoclavicular ligament complex and provides an alternative
technique to treat AC joint separations.
Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
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Each author certifies that his or her institution has approved or waived approval for the human protocol for this investigation
and that all investigations were conducted in conformity with ethical principles of research.