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Modified All-Arthroscopic Coracoclavicular Ligament Reconstruction Using a Hamstring Allograft

February 19, 2016

Contributors: Antonio Cusano, BS; Antonio Cusano, BS

Acromioclavicular joint injuries are common shoulder injuries that typically result from direct trauma to the acromion during a fall or participation in contact sports with the arm in an adducted position. The spectrum of acromioclavicular joint injuries ranges in severity from minor sprains to complete dislocations with disruption of the acromioclavicular ligament, coracoclavicular ligament, and deltopecotral fascia. This variation in injury in combination with an improved understanding of the anatomy and biomechanics of the acromioclavicular joint has led to the development of various surgical techniques that help mitigate pain and restore function. However, most standard procedures require an open approach, extensive soft-tissue dissection, disruption of part of the deltoid insertion, and an open incision. These procedures are associated with an increased risk for neurovascular impairment because of limited visualization medial to the coracoid. Arthroscopic-assisted coracoclavicular ligament reconstruction has emerged as a viable alternative because it is not associated with such complications and surgical challenges. Various arthroscopic acromioclavicular joint and coracoclavicular ligament reconstruction techniques have been described. Some techniques attempt to release the rotator interval or superior and middle glenohumeral ligaments to clear the coracoid, whereas other techniques involve the use of plates or screws to reduce the acromioclavicular joint or involve a subacromial approach to isolate the coracoid and allow for easy graft passage. This video describes a novel technique for modified all-arthroscopic coracoclavicular ligament reconstruction with the use of hamstring allograft for the management of a type V acromioclavicular joint separation. The goal of this video is to provide a detailed, stepwise description of this new and modified approach. The narration will explain the technique, the surgical indications, and technical pearls and pitfalls.

Results for "Shoulder Preservation"

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