Arthroscopic reconstruction for acromioclavicular dislocations

Acromioclavicular joint dislocations are common shoulder injuries whose treatment has remained largely nonoperative. Although most patients with these injuries fare well with conservative management, a significant number of people exist who would benefit from surgical intervention. Most operative techniques developed to treat this injury involve open surgery and require considerable detachment of deltoid muscle with subcoracoid dissection. Many orthopaedic surgeons have been discouraged from attempting acroimoclavicular joint reconstruction because of the need for this anterior shoulder dissection and concerns about the final cosmetic results. Arthroscopic reconstruction of the coracoclavicular ligaments was created to introduce a less invasive method to achieve an anatomic reconstruction of these ligaments while simultaneously achieving a cosmetically pleasing outcome. The evolution of this technique has led to the development of reliable instrumentation, strong and resilient implants, and reproducible results making arthroscopic reconstruction an attractive method to treat significant acromioclavicular joint separations. This article serves as an update to our original description of the technique and includes clinical follow-up. (C) 2004 Elsevier Inc. All rights reserved.