Acromioclavicular joint dislocation accounts for 9%-12% of all injuries of the shoulder. It is generally accepted that patients with grades IV and V injuries benefit from operative treatment. Although the optimal management for grade III injuries remains contentious, many authors agree that surgical treatment seems to be a feasible choice for physically active young adults. Surgical stabilization of the AC joint could prevent disabling pain, weakness, and deformity. Numerous surgical methods have been described for AC joint reconstruction. While nearly every operative method has its advantage, each one is associated with disappointing failure cases. The use of suture anchors for coracoclavicular reconstruction could potentially diminish the risk of neurovascular injury and clavicle or coracoid fracture. Also, there is no need for a secondary operation for implant removal.

To evaluate the outcome of coracoclavicular ligament reconstruction with suture anchors for the treatment of acute acromioclavicular joint dislocation.

The study involved 13 patients with acute acromioclavicular joint dislocation treated surgically from February 2014 to June 2015. There were 8 males and 5 females at average age (40.0±15.6) years. The dislocated acromioclavicular joint was reduced and maintained with suture anchors through coracoclavicular ligament reconstruction. Computed tomography with 3-D reconstruction of the injured shoulder was performed on each patient postoperatively for the assessment of the accuracy of the suture anchor placement in the coracoid process. Radiographs of both shoulders were taken for evaluating the maintenance of the acromioclavicular joint reduction and measuring the coracoclavicular distance at each follow-up visit. The range of motion of the shoulder, VAS score and Constant-Murley score were all recorded at final follow-up.

The average forward flexion of the shoulder was (171.5±9.9) °. The average external rotation was (70.8±7.6) °. The internal rotation was T8. The mean VAS score was (0.3±0.6) . The mean Constant-Murley score was (92.4±7.8) . The mean coracoclavicular distance of the affected side was (8.9±3.0) mm and that of the contralateral shoulder was (7.7±1.7) mm at the final follow up. The difference was not significant (P>0.05) . 23 of the 26 anchors implanted in the coracoid process had good position. There was one anchor inserted too deeply in a wrong angle and penetrated the under surface of the coracoid process. Both of the two anchors in one case were placed too medially. One patient developed complete loss of reduction and another had partial loss of reduction, and the Constant-Murley score were 74 and 84 respectively.

With this minimally invasive approach and limited exposure of the coracoid, a surgeon can precisely place the suture anchors at the anatomical insertions of the coracoclavicular ligament on the coracoid process. Acromioclavicular joint reduction with horizontal and vertical stability is achieved with satisfactory results.