A Single-Tunnel Technique for Coracoclavicular and Acromioclavicular Ligament Reconstruction

Abstract

Acromioclavicular (AC) joint separation is a common injury seen in the young adult athletic population. Both the indications for surgical management and the best operative technique remain controversial. One of the most popular reconstruction techniques is the anatomic double-tunnel coracoclavicular (CC) ligament reconstruction. However, there have been several case reports of clavicle fractures with this technique. This article presents a single-tunnel reconstruction technique that aims to restore both the CC and AC ligament function, while minimizing fracture risk.

Biomechanical Evaluation of a Single- Versus Double-Tunnel Coracoclavicular Ligament Reconstruction With Acromioclavicular Stabilization for Acromioclavicular Joint Injuries

“…None of the suture anchors penetrated into the subacromial space. For further illustrations of the ST CC ligament reconstruction technique, see Banffy et al 2…”

“…This logic sparked creation of this single-tunnel (ST) CC ligament reconstruction technique 2 and other ST CC ligament reconstruction techniques 6,21 that re-create the anatomic relationship of the CC ligaments while decreasing the risk of clavicle fractures. The purpose of this study is to evaluate the biomechanics of this ST CC ligament reconstruction and to compare it with the DT CC ligament reconstruction technique.…”

An Accuracy Comparison of Minimally Invasive Transclavicular‐Transcortical Drilling with Free‐Hand, C‐Shape and Assembly‐Type Guide Device: An In Vitro Study

“…The Advantages of the Assembly Guide Device in Transclavicular-Transcoracoid Drilling Compared to c-arm fluoroscopy 17,18 and arthroscopically assisted drilling 8,15 , guide techniques have the advantages of being relatively inexpensive, simple, effective, and free of radiation exposure 6,16,20 . But it is very difficult to locate the basement tunnel under the coracoid process without arthroscopic assistance.…”

“…However, this technique is associated with several problems such as a more obvious scar, slower soft tissue healing, and residual instability 3 , 14 . Minimally invasive procedures have been recently introduced for AR to avoid large incisions and extensive soft tissue dissection 8 , 15 , 16 . However, it is challenging to achieve an accurate transclavicular‐transcoracoid drilling with minimally invasive incisions for inexperienced surgeons with inadequate exposure to the operative field.…”

Arthroscopic-Assisted Acromioclavicular Joint Dislocation Repair: A Modified Technique for Horizontal Stabilization Using Suture Anchors

“…Because the superior AC ligaments are the main stabilizer against anteriorposterior forces and their instability is associated with worse functional outcomes, 1-3 more attention is being directed toward their repair, with multiple techniques already described. 2,4,5 Knowledge of the biomechanics and anatomy is a cornerstone to anatomic repair of these ligaments; however, only recently have some studies been published regarding the morphologic patterns of AC ligament injury. 6 The surgical treatment of acute AC injuries relies on the biological healing potential of the torn ligaments.…”