Treatment of Chronic Acromioclavicular Joint Dislocation

ACJ injuries are a common injury with no clear consensus which surgical techniques should be preferred in chronic ACJ dislocations. Hybrid techniques using tendon grafts and non-biologic suture button systems are used to support proper healing of the torn structures and ensure optimal stabilization of the ACJ. In chronic ACJ stabilizations, focus should be placed on restoring physiological horizontal and vertical ACJ stability. As the AC capsule and deltotrapezial fascia are significantly contributing to horizontal stability, augmentation of the AC capsule is required. Biological reconstruction of the AC and CC ligaments using small 4-mm drill holes at the distal clavicle and the coracoid process reduces the risk of postoperative fractures as well as enhances horizontal and vertical stability. Further, by looping the graft in front of the clavicle, the number of required bone tunnels can be minimized.