Acromioclavicular joint dislocation is common in the clinic, mostly in young adults and people who like sports. Patients with less severe injuries, such as Rockwood I, II, and some III, can be treated with conservative therapy with satisfactory results. In contrast, Rockwood types IV, V, and VI with severe acromioclavicular dislocation require surgery. The most controversial treatment is Rockwood type III, where persistent dislocation of the acromioclavicular joint leads to persistent pain and dysfunction due to failure of conservative treatment. However, due to the obsolescence stage at the time of treatment, different clinical reports have a certain incidence of poor reduction, loss of reduction, and residual pain. We proposed the method of coracoclavicular ligament + acromioclavicular ligament reconstruction under arthroscopy, which gives full play to the advantages of minimally invasive surgery and has certain significance for improving postoperative shoulder joint function and alleviating pain.

To investigate the effect of arthroscopic reconstruction of coracoclavicular and acromioclavicular ligaments in treating chronic Rockwood type III acromioclavicular joint dislocation.

A total of 14 patients diagnosed with old acromioclavicular dislocation from January 2016 to December 2020 were selected, including 8 males and 6 females, with an average age of (37.2±10.1) years and an average injury time of (13.4±3.5) months, and 7 patients with dominant shoulder joint involved. All underwent arthroscopic coracoclavicular + acromioclavicular ligament reconstruction. Each patient was followed up at different postoperative time points (1, 3, 6, 12 months after surgery) , and pain (VAS score) and shoulder function (UCLA score) were evaluated.

Fourteen patients diagnosed with obsolete acromioclavicular dislocation (all Rockwood type III) entered the study. They completed surgery, and 12 were thoroughly followed up, with a mean follow-up of (26.3±8.6) months (12-36 months) . (1) VAS score: Preoperative, postoperative 1 month, 3 months, 6 months and 12 months scores were (5.667±0.414) point, (5.583±0.288) point, (4.583±0.229) point, (2.833±0.271) point, (0.538±0.193) point, respectively. Compared with pre-operation, all patients showed pain relief at 3, 6 and 12 months after surgery, and the degree of pain relief (changes in VAS score) at 6 and 12 months after surgery was statistically improved (P<0.001) . (2) UCLA score: Preoperative, postoperative 1 month, 3 months, 6 months and 12 months scores were (19.083±0.468) point, (18.583±0.434) point, (21.000±0.628) point, (25.750±0.579) point, (32.750±0.509) point, respectively. Compared with pre-operation, UCLA scores of all patients at the 3rd, 6th and 12th months follow-up was improved, and the UCLA scores improvement at 6- and 12-months follow-up was statistically different (P<0.001) .

Arthroscopic reconstruction of coracoclavicular and acromioclavicular ligaments can relieve pain and improve shoulder function in patients with chronic acromioclavicular dislocation with less trauma.