초록/요약

Purpose: To introduce an arthroscopically assisted coracoclavicular (CC) fixation technique using a cortical fixation button device and to evaluate the clinical and radiologic outcomes in patients with acute acromioclavicular (AC) dislocation who were treated with the technique. Methods: Twenty-one consecutive patients with grade III and V acute AC dislocation who underwent arthroscopically assisted CC ligament reconstruction using a cortical fixation button device were prospectively enrolled. Our fixation technique involved using a cortical fixation button device consisting of 1 coracoid button and 2 clavicular buttons connected with 2 suture tapes to reconstruct the conoid and trapezoid ligaments, respectively. Clinical outcomes were evaluated and CC distance and horizontal displacement of the AC joint were measured. Results: The mean follow-up period was 27.2 months (range, 24-32 months). The average CC distance of the injured shoulder was 17.2 +/- 5.2 mm preoperatively, which represented an increase of 103% +/- 42% compared with the uninjured shoulder. The CC distance was significantly reduced to 8.5 +/- 1.5 mm after surgery (P < .001). At the final follow-up, the CC distance was maintained in 20 patients (95%) without loss of reduction. No significant radiologic difference was found in horizontal displacement of the AC joint immediately after the operation and at the final follow-up (P = .422). The average American Shoulder and Elbow Surgeons and Constant scores were 95.7 +/- 3.6 and 95.4 +/- 3.4, respectively. There were 3 complications, including 1 reduction loss, 1 coracoid process fracture, and 1 CC interval ossification. Conclusions: Satisfactory clinical and radiologic outcomes were obtained simultaneously by arthroscopically assisted CC reconstruction using cortical fixation buttons. This reconstruction technique provided sufficient stability of the AC joint by using 2 clavicular holes to reconstruct the conoid and trapezoid ligaments separately. Therefore, arthroscopically assisted CC ligament reconstruction using a cortical fixation button device for management of acute AC dislocation is considered a viable treatment option for restoring stability to the AC joint.