All-Endoscopic Treatment of Acute Acromioclavicular Joint Dislocation: Coracoclavicular Double Cerclage EndoButton Technique and Acromioclavicular Stabilization Using the Coracoacromial Ligament

Abstract

High-grade the acromioclavicular joint (ACJ) dislocations can be treated surgically. Endoscopic techniques to stabilize the ACJ using an EndoButton suture technique for coracoclavicular (CC) fixation have been shown to be safe and reproducible. Several studies have demonstrated the benefit of stabilizing the ACJ to reduce postoperative horizontal instability. This Technical Note presents a full-endoscopic technique for acute ACJ dislocations using a double-stranded EndoButton cerclage technique for CC reconstruction and an additional coracoacromial ligament transfer for acromioclavicular reconstruction. An autologous coracoacromial ligament transfer to the lateral clavicle increases stability in the horizontal plane and reduces the risk of anteroposterior recurrent instability. Clinical studies need to show whether additive ACJ fixation in addition to the all-endoscopic double cerclage EndoButton CC stabilization technique is in fact beneficial.