Arthroscopic-Assisted Coracoclavicular Ligament Reconstruction: Clinical Outcomes and Return to Activity at Mean 6-Year Follow-Up

Editorial Commentary: Arthroscopic-Assisted Coracoclavicular Ligament Reconstruction Leads to Improved Patient-Reported Outcomes, But Patient Satisfaction Is a Harder Threshold to PASS

“…Initial methods to restore AC joint stability described transfer of the coracoacromial ligament to the distal clavicle (i.e., Weaver-Dunn procedure), while more modern techniques focus on more anatomic reconstructions of the coracoclavicular (CC) ligaments through either open or arthroscopic-assisted approaches. 1,2 Results of arthroscopy-assisted CC reconstruction have, thus far, been promising, with high rates of patient satisfaction and improved patientreported outcome scores (PRO scores) after surgery, [3][4][5][6] albeit with residual risk of recurrent deformity due to loss of anatomic reduction.…”

A Technique for a More Accurate Acromioclavicular Joint Reduction in Arthroscopic Coracoclavicular Stabilization of Acromioclavicular Joint Dislocation

“…A cromioclavicular (AC) dislocations represent up to 12% of all shoulder injuries 1 and, although no gold standard treatment has been established, there is currently a tendency toward an arthroscopic approach, which has been demonstrated to be extremely safe and reliable. 1,2 However, despite significant evolution in fixation materials and techniques, postoperative loss of reduction is a concern, affecting up to 28% of operated patients. 3 The objective of this technical note is to describe a technique that ensures accurate reduction of the AC joint and minimizes loss of reduction following coracoclavicular (CC) arthroscopic fixation.…”

Editorial Commentary: Acute Repair of the Acromioclavicular Joint Capsule and Ligaments and Deltotrapezial Fascia Could Allow Biological Healing of High-Grade Acromioclavicular Separation—Coracoclavicular Ligament Graft Augmentation Could Be Indicated if Time to Surgery Is Greater Than 3 Weeks

“…For this reason, reconstructive strategies must give the same importance to AC reconstruction as to CC reconstruction. This evidence could explain why despite reports of some loss of reduction in the vertical plane after CC reconstruction, patients still have good subjective outcomes, particularly when clinical examination findings show that the ACJ posterior translation test result is negative, as reported by Garofalo et al, 13 as well as the literature review by Gowd et al 14 Lamplot et al 4 failed to show better results in patients in whom reconstruction of the AC capsule and ligaments was associated with CC reconstruction. However, looking at their series shows that the 8% of cases that were not able to resume activity fell into the group that did not receive any associated AC reconstruction.…”

“…In the case series reported by Lamplot et al, 4 the tendon in all cases was passed around the base of the coracoid without any tunnels; however, it was secured in different ways at the level of the clavicle. Although there are some concerns about the possibility of healing of tissue graft around the coracoid base without any fixation, we could eliminate the risk of coracoid complications in this way.…”

“…A last important point regarding the study by Lamplot et al 4 is related to the use of arthroscopy when performing ACJ reconstruction. When we look at outcomes previously reported with open procedures, shifting to arthroscopy does not appear to provide significant improvement.…”