Open Acromioclavicular (AC) Reconstruction

The acromioclavicular joint is formed by the ends of the acromion and the shoulder blade. The AC joint can be injured during sports or accidents. Open surgical reconstruction of the AC joint may be indicated to relieve pain and to restore normal shoulder function. The procedure may involve removal of a part of the bone and repositioning of the clavicle.

Our technique for acromioclavicular joint reconstruction provides a variation on coracoclavicular ligament reconstruction to also include acromioclavicular ligament reconstruction. An oblique acromial tunnel is drilled, and the medial limb of the gracilis graft, after being crossed and passed beneath the coracoid and through the clavicle, is passed through this acromial tunnel and sutured to the trapezoid graft limb after appropriate tensioning. Tenodesis screws are not placed in the bone tunnels to avoid graft fraying, and initial forces on the graft are offloaded with braided absorbable sutures passed around the clavicle.

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