TRIP

Clinical Results of Single-Tunnel Coracoclavicular Ligament Reconstruction Using Autogenous Semitendinosus Tendon.

American Journal of Sports Medicine, 2010

BACKGROUND: Over 60 repair/reconstruction techniques have been described for the treatment of coracoclavicular (CC) ligament injuries.
PURPOSE: To report the functional and radiological outcomes of single-tunnel CC ligament reconstruction using autogenous semitendinosus tendon.
METHODS: Between August 2005 and January 2008, a total of 21 patients, 16 patients (14 men, 2 women) with a Rockwood type IV, type V, or a chronic type III acromioclavicular (AC) dislocation and 5 patients (4 men, 1 woman) with a painful nonunited distal clavicle fracture with CC separation, underwent CC reconstructive surgery using a semitendinosus autograft.
The mean follow-up was 33 months (range, 18-47), and the mean patient age was 39.8 years (range, 18-70).
Chronic type III AC dislocations and nonunited distal clavicle fractures with CC separation were scored using preoperative AC scoring (AC Joint Separation Questionnaire).
Constant, University of California-Los Angeles (UCLA), and AC scores were evaluated for all patients at final follow-up.
RESULTS: At the final follow-up, 10 patients achieved an "excellent" result and 11 a "good" result according to the AC scoring scheme.
In the anteroposterior (AP) plane, 17 (81%) of the 21 patients maintained complete reduction, and 1 of the remaining 4, a manual laborer, had complete reduction loss.
Of the 17 patients with an axillary view at final follow-up, 1 patient (5.9%) showed partial subluxation, although no subluxation was observed in the AP radiograph.
CONCLUSION: Single-tunnel CC reconstruction with an autogenous hamstring tendon graft after a mean follow-up of 33 months (range, 18-47) appears to be a satisfactory means of treating acute Rockwood type IV, V, chronic type III, and painful nonunited distal clavicle fractures with CC separation.