Arthroscopically Assisted Acromioclavicular and Coracoclavicular Reconstruction with a Looped Braided Polyester Suture Band and Buckle Device

Acromioclavicular (AC) joint injuries occur with a traumatic load to the lateral aspect of the shoulder and account for 9% of all shoulder girdle injuries. Rockwood classified AC joint injuries as type I though type VI, based on severity of injury, radiographic findings, and reducibility of the AC joint. Type I and II injuries are typically managed nonoperatively, whereas type IV, V, and VI are managed operatively to address the significant soft tissue disruption, persistent AC joint instability, and apical shoulder deformation. Treatment of type III injuries remain controversial. Several techniques have been described to treat AC joint injuries with no consensus for optimal treatment. “Anatomic” double-tunnel coracoclavicular ligament reconstruction is one currently popular technique to address AC joint injuries; however, clavicle and coracoid fractures are well-described complications of this technique. The objective of this technical report is to describe our preferred technique to address AC joint injuries. This technique involves using a looped braided polyester prosthetic band and low-profile buckle with allograft augmentation using a device to pass materials around the coracoid process.