Advertisement

Arthroscopic Coracoclavicular Ligament Reconstruction Using Biologic and Suture Fixation

Published:February 16, 2007DOI:https://doi.org/10.1016/j.arthro.2006.10.005

      Abstract

      Presented in this report is a modified arthroscopic approach to acromioclavicular joint reconstruction via suture and allograft fixation. An arthroscopic approach is used to expose the base of the coracoid by use of electrocautery. After an open distal clavicle excision is performed, clavicular and coracoid tunnels are created under arthroscopic visualization as previously described by Wolf and Pennington. The myotendinous end of a semitendinosus allograft is sutured to a Spider plate (Kinetikos Medical, San Diego, CA). The tendinous end of the graft is prepared with a running baseball stitch. A Nitinol wire with a loop end (Arthrex, Naples, FL) is used to pass 2 free FiberTape sutures (Arthrex) and the leading sutures from the tendinous end of the graft through the clavicular and coracoid tunnels, exiting out the anterior portal. One of the FiberTape sutures is retrieved with a grasper and passed over the anterior aspect of the distal clavicle. The second FiberTape suture and the allograft are passed over the distal end of the resected clavicle. While the acromioclavicular joint is held reduced, the FiberTape sutures are tied to the plate and the allograft is tensioned medially until the plate is embedded against the superior surface of the clavicle. The tendinous end of the graft is secured to the superior surface of the clavicle with a Bio-tenodesis screw (Arthrex) medial to the clavicular tunnel.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Arthroscopy
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Wolf E.M.
        • Pennington W.T.
        Arthroscopic reconstruction for acromioclavicular joint dislocation.
        Arthroscopy. 2001; 17: 558-563
        • Wolf E.M.
        • Fragomen A.T.
        Arthroscopic reconstruction of the coracoclavicular ligaments for acromioclavicular joint separations.
        Oper Tech Sports Med. 2004; 12: 49-55
        • Imhoff A.B.
        • Chernchujit B.
        Arthroscopic anatomic stabilization of acromioclavicular joint dislocation.
        Oper Tech Sports Med. 2004; 12: 43-48
        • Mazzocca A.D.
        • Conway J.E.
        • Johnson S.
        • et al.
        The anatomic coracoclavicular ligament reconstruction.
        Oper Tech Sports Med. 2004; 12: 56-61
        • Morrison D.S.
        • Lemos M.J.
        Acromioclavicular joint separation.
        Am J Sports Med. 1995; 23: 105-110