Complications Related to Anatomic Reconstruction of the Coracoclavicular Ligaments

Abstract

Newer techniques for the anatomic reconstruction of the CC ligaments may have steep learning curves associated with complications such as coracoid and clavicle fractures. Loss of reduction continues to be associated with the operative treatment of high-grade AC separations. Further refinement of surgical technique and experience with the operative treatment of AC separation is warranted.

Acromioclavicular joint separations

“…Furthermore, unpublished results from this institution suggest a complication rate of 22 % (13/59) with a 79 % survivorship at 24 months in patients undergoing either suture button or tendon allograft AC reconstruction procedures. Many of the complications were similar to that of Milewski et al [59] including coracoid and clavicular fractures, hardware failure, and symptomatic loss of reduction, however, most patients significantly improved with regard to pain, function, and return to sport.…”

“…Good to excellent clinical outcomes have been reported, yet complications do occur [14,15,[59][60][61].…”

“…The potential problems of graft reconstruction techniques are supported by a recent study conducted by Milewski et al [59] in which an anatomic graft reconstruction was performed using either 2 biotenodesis screws (by passing the graft around the coracoid process [n017]) or a hybrid device (GraftRope, Arthrex Inc., Naples, FL) (n010). They found 8 complications (80 %) in the hybrid device group including 2 coracoid fractures, 5 re-dislocations, and 1 intraoperative failure of the coracoid button fixation.…”

Functional Assessment Following Treatment of Acromioclavicular Joint Dislocation by Screw and Tension Band Wiring

“…[4] Non -operative treatment like strapping, bracing, splinting etc fail to perform the job because of interposition of articular disc, frayed capsular ligament, fragments of articular cartilage between acromian and clavicle and subsequent complications, which demands further surgical correction. [5][6][7] Different operative procedures for management of Type III injuries have been described such as acromioclavicular reduction and fixation, Coracoclavicular repair or reconstruction, combined repair, coraco-clavicular fusion, dynamic muscle transfer from tip of coracoids process, distal clavicle excision etc. in our study we have used AC fixation with screw from clavicle to coracoid process and tension band wire along with repair of ligaments if found torn.…”

Arthroscopic Anatomic Coracoclavicular Ligament Repair Using a 6-Strand Polyester Suture Tape and Cortical Button Construct

“…Despite these advances, complications such as clavicular fracture, coracoid fracture, and loss of reduction have been reported. [2][3][4] The optimal method of fixation would provide for anatomic repair or reconstruction of both ligaments, minimize the number and diameter of clavicle and coracoid tunnels, and provide sufficient strength to maintain reduction until the native ligaments have healed. We describe our technique for arthroscopically assisted anatomic coracoclavicular ligament repair of acute high-grade AC separations using a 6-strand suture tape and cortical button construct.…”