Minimally invasive double endobutton of coracoclavicular ligament reconstruction for the treatment of acute complete acromioclavicular joint dislocation

Abstract

Background Numerous procedures have been described for the operative management of acromioclavicular (AC) joint injuries. Some of these techniques have focused on anatomical restoration of the coracoclavicular ligaments to achieve optimal clinical outcomes. This report introduces a novel procedure for the reconstruction of complete AC joint dislocation by using double endobutton technique to separately reconstruct the conoid and the trapezoid portions of the coracoclavicular ligament. The aim of this prospective study was to assess the functional and radiological efficacy of minimally invasive double endobutton of coracoclavicular ligament reconstruction in the treatment of acute complete AC joint dislocation. Patients and methods During the period from January 2014 to September 2015, 20 patients with Rockwood types IV and V AC joint dislocation were treated with minimal invasive double endobutton of coracoclavicular ligament reconstruction. The improvement in shoulder functions was assessed using a Constant score and visual analog scale system. Results The authors evaluated the preliminary clinical and radiological results of this technique in patients with acute complete dislocation of the AC joint. All patients achieved a significant improvement in the pain and function of shoulder. Excellent reduction of the AC joint was maintained. The mean follow-up period was 20.6±5.4 months. The mean Constant scores improved from 25.2±6.6 preoperatively to 92.4±6.5 postoperatively, whereas the mean visual analog scale score decreased from 5.9±1.4 preoperatively to 1.2±0.9 postoperatively; significant differences were observed. The final follow-up revealed that excellent outcomes were achieved in 16 (80%) patients and good outcome in four (20%) patients. Conclusion Preliminary follow-up results for the patients indicated that the method is a safe, practical, and effective surgical approach for treatment of acute complete AC joint dislocation and significantly relieves pain, effectively improves the function of shoulder, and can be used as an alternative to arthroscopic and open methods for acute complete AC joint dislocations.