Background. Nonsurgical treatment of Acromioclavicular joint dislocations is well established. Most patients treated conservatively do well, however, some of them develop persistent symptoms. We have used two different surgical reconstruction techniques for Chronic ACJ dislocation stabilization. The study evaluates the effectiveness of a braided polyester prosthetic ligament and modified Weaver-Dunn reconstruction methods. Methods. 55 patients (mean age 42) with Chronic Acromioclavicular joint dislocation were included in this study. They were treated either by a modified Weaver-Dunn method or a braided polyester prosthetic ligament. Patients were assessed using Oxford shoulder score preoperatively and a minimum of 12 months postoperatively. Results. 31 patients (mean age 40, M=24, F=7) were treated by Modified WD method and 24 patients (mean age 44, M=18, F=6) by Surgilig at a mean21 and 24 months post injury. The mode of injury, presentation of symptoms, grade of injury and mean time at surgery post injury was similar in both the groups. There was a significant improvement (p<0.05) in mean pre and postoperative Oxford Shoulder score in both the groups (WD Mean preop OSS=28, postop OSS= 42, Surgilig Mean preop OSS=26, postop OSS=45). The Surgilig group returned to work significantly earlier (Surgilig; mean 6 wks, WD mean 14 wks). There were 3 failures in the WD group and 1 in Surgilig. Superficial infection was seen in 3 patients requiring antibiotics only. Most of the patients from both groups were satisfied with their result except for 3 patients, one which developed complex regional pain syndrome and two developed secondary shoulder problems resulting in ongoing pain. Conclusions. Chronic ACJ dislocations can be successfully treated surgically by either Weaver-Dunn or Surgilig based on similar satisfaction scores amongst patients of both groups. In this study Surgilig had higher overall success rate, less incidence of failure and allowed earlier return to work

Osteolysis has been reported following ACJ reconstruction with a synthetic graft. We present the first study into its prevalence and pattern, and its effect on patient outcome. Patients who underwent treatment of an unstable ACJ injury using the Surgilig/LockDown implant were identified via our database. Patients were invited to attend a dedicated outpatient clinic for clinical examination, radiographic evaluation, and completion of outcome scoring. Patients who were unable to attend were contacted by telephone. 49 patients were identified. We assessed 21 clinically at a mean of 7 years post-procedure (range 3–11 years). All had radiographic evidence of distal clavicle and coracoid osteolysis. We did not observe progression of osteolysis from the final post-operative radiographs. A further 13 were contacted by phone. The mean Oxford Shoulder Score was 43 (range 31–48) and mean DASH score was 8.5 (range 3–71). The average Patient Global Impression of Change score was 6 (range 2–7). Six patients underwent removal of a prominent screw at a mean of 2 years after surgery; the pattern of osteolysis was no different in this group. All patients had comparable abduction, forward flexion and internal rotation to their uninjured shoulder. We did not observe any relationship between patient demographics, position of implant or etiology and the pattern of osteolysis. Osteolysis of the distal clavicle and/or coracoid is always seen following synthetic reconstruction of the ACJ using this implant, but is non-progressive. Range of shoulder movement is largely unaffected and patient outcomes remain high