Anatomical reconstruction of coracoclavicular and acromioclavicular ligaments using an autologous tendon graft provides excellent outcomes in acute acromioclavicular joint dislocation.

Purpose: Common surgical techniques for managing acute acromioclavicular (AC) injuries include reconstruction of the coracoclavicular (CC) ligaments using tendon grafts or high-strength artificial looping materials, as well as fixation with a hook plate. This study presents a thorough analysis of the outcomes of anatomical reconstruction of both the CC and AC ligaments using a single-strand semitendinosus tendon graft.

Methods: All patients with acute AC joint dislocation who underwent anatomical reconstruction of the CC and AC ligaments between 2017 and 2022 were included in this retrospective analysis. Postoperative evaluation of clinical and functional outcomes was conducted using the Simple Shoulder Test, QuickDASH and Constant-Murley scores. Radiographic assessments were used to determine any loss of reduction.

Results: The study included twelve male patients with a mean age of 37.8 years (range: 23-64). According to the Rockwood classification, three patients had Type III, three had Type IV, and six had Type V dislocations. All patients underwent anatomical reconstruction of the CC and AC ligaments. The most recent follow-up, with a mean duration of 31.8 months (range: 12-64 months), demonstrated excellent postoperative functional outcomes, with scores of 87 (SD = 4.1) for the Simple Shoulder Test, 2.9 (SD = 4.5) for QuickDASH and 89.7 (SD = 3.1) for the Constant-Murley score. Radiographic assessment showed a reduction in CC distance from a preoperative mean of 16.6-8.9 mm at final follow-up. Partial loss of reduction was noted in two patients; however, neither exhibited functional impairment or activity limitations that required surgical revision. Minor complications included wound dehiscence (one patient) and persistent numbness at the incision site (two patients).

Conclusions: Reconstruction of the CC and AC ligaments using an autologous semitendinosus tendon graft for acute AC joint dislocation results in excellent clinical outcomes and satisfactory radiographic findings.

Level of evidence: Level IV.