What to do if it goes wrong? Solutions after failure

The surgical management of acromioclavicular joint injuries has been evolved during the last decade. Anatomic coracoclavicular ligament reconstruction techniques usually with the addition of acromioclavicular joint cerclage is considered the best option in order to achieve good function, stability and elimination of pain. Most of these techniques are performed arthroscopically or arthroscopically assisted and make use of cortical fixation devices, strong sutures and bone tunnels through clavicle and coracoid process. However, the increasing popularity of such new methods has resulted in some distinct new complications: loss of reduction, clavicle and/or coracoid process fractures, tunnel widening, and persistent horizontal instability. These complications and their appropriate management are discussed in this chapter.