Acromioclavicular Dislocations. A Novel Surgical Technique for biological reconstruction of coraco-claviculer ligaments

Abstract Background: Acromioclavicular joint represents the link between the clavicle and the scapula, which is responsible for the synchronized dynamics of shoulder girdle. Several surgical tactics for acromioclavicular joint dislocation has been described which aim to restore joint congruity and mechanical stability. Purpose: of this study was to asses functional, radiological outcomes and complications of coracoclavicular (CC) ligaments reconstruction utilizing a novel technique sacrificing the lateral half of conjoint tendon and passé it through holes in the clavicle. Patients &Methods: Between July 2017 to December 2020, a prospective case series study was conducted in 3 centers. Institutional review board approval was gained for this technical note and informed consent was obtained from all study participants including 25 patients with types III ,IV and V AC injuries. All patients underwent CC ligament reconstruction by using lateral half of conjoint tendon. Results: After a mean follow up period of 18±2.3 months patients showed significant improvement between mean preoperative and postoperative pain, ROM, Constant, ASES scores and CC distance difference. The patients were evaluated for pain, range of motion (ROM), radiologic findings (CC distance difference between both sides), American Shoulder and Elbow Surgeons (ASES), and Constant scores. Postoperative complications were recorded and assessment of time of returning to the work was done. The evaluation was done preoperatively and each time of follow up with a minimum period of one year. Some complications evolved in this series included: superficial wound infection occurred in two cases and fracture clavicle occurred in one case Conclusion: The described technique is simple, reproducible and is anticipated to reduce the cost of the operative procedure significantly. Level of evidence/ Level IV case series study