Abstract
Introduction: Since the first repair of coracoclavicular ligament complex in 1886 there have been more than sixty operative procedures described in the literature. Open methods of reduction and stabilization of AC joint are associated with increased morbidity and violation to the surrounding soft tissue and result in less cosmetic scar and possibly a further surgery to remove the hardware. We propose an arthroscopic technique using Tightrope (Arthrex) to reduce and stabilize the joint with low morbidity.
Materials and Methods: We reviewed 26 (21 male, 5 female) consecutive patient’s (notes, radiographs and Oxford shoulder score) who underwent arthroscopic stabilization of AC joint. The average age was 33 years (min.22, max.53). The average period from injury to surgery was nine days. The primary indication for surgery was grade IV to VI injuries and grade III injuries in upper extremity athletes and workers with the need for overhead activities. Patient’s satisfaction and functional improvement were observed.
Results: Short-term preliminary results are encouraging and show an excellent functional outcome without significant residual pain. We had four radiological recurrences of the deformity, two of which were completely asymptomatic, one associated with painless clicking and one requested revision surgery (same technique) to improve cosmesis. There were no infections or neurovascular injury in this series.
Conclusion: This method of surgically stabilizing the AC joint is minimally invasive, done as a day case and yielding satisfactory results. Among the advantages of the technique are that it does not require specific expensive instrumentation and offers the possibility of visualizing the glenohumeral joint for associated lesions. However, there is a learning curve and experience with arthroscopic procedures is essential.
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