Anatomic Acromioclavicular Ligament Reconstruction Using Semitendinosus Autograft With Suture Augmentation: Surgical Technique

Acromioclavicular (AC) joint separations are common injuries and account for 3.2% of shoulder injuries. These injuries typically occur among adolescent and young adult athletes during contact sports, such as hockey, wrestling, and rugby. Low-grade AC joint separations (Rockwood grade I-II) are often successfully treated nonoperatively. High-grade AC joint separations (Rockwood grade IV-VI) have the potential to alter scapular kinematics, causing painful and restricted motion, and are often treated surgically. Over 150 surgical techniques have been described to treat AC joint separations. Techniques vary in the types of implants used (screws, pins), use of anatomic or nonanatomic reconstructions, number of drill holes used, use of arthroscopic or open procedures, use of distal clavicle resection, and types of augmentation (allografts, autografts, sutures). The procedure can be expensive, with the implants and grafts costing varied amounts and, at times, thousands of dollars. The purpose of this Technical Note is to describe an inexpensive method of open anatomic AC joint reconstruction using a single bone tunnel, suture tape, and a semitendinosus autograft.