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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 (AC) joint injuries are common shoulder injuries that typically result from direct trauma to the acromion following 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 AC ligament, coracoclavicular (CC) ligament, and deltopecotral fascia. This variation coupled with an improved understanding of the anatomy and biomechanics of the AC joint has led to the development of many surgical techniques that work to 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 thus carry an increased risk of neurovascular impairment due to limited visualization medial to the coracoid. For this reason, arthroscopically assisted CC ligament reconstruction has emerged as a viable alternative as it is not associated with such complications and surgical challenges, Since its initial onset, various arthroscopic AC joint and CC ligament reconstruction techniques have been described. Some attempt to release the rotator interval or superior and middle glenohumeral ligaments to clear the coracoid, while others either utilize plates or screws to reduce the AC joint or use a subacromial approach to isolate the coracoid and allow easy passage of the graft. Here, we describe a novel technique of modified all-arthroscopic CC ligament reconstruction with hamstring allograft for a type V AC 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 itself, as well as surgical indications and technical pearls and pitfalls.

Results for "Shoulder Preservation"

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