Clinical outcomes of coracoclavicular ligament reconstructions using tendon grafts.
BACKGROUND
Numerous techniques for reconstruction of the coracoclavicular ligaments have been developed to treat acromioclavicular joint separations. A new, stronger method to reconstruct the coracoclavicular ligaments using semitendinosus tendon allografts has been previously described. No outcome studies have been published on this new procedure.


OBJECTIVE
Reconstruction of the coracoclavicular ligaments using tendon grafts produces excellent functional results.


METHODS
Case series; Level of evidence, 4.


METHODS
Nine patients underwent coracoclavicular ligament reconstruction using augmented cadaveric semitendinosus tendon allografts after a grade V acromioclavicular separation. All patients were evaluated for range of motion, strength, closed kinetic chain testing, the American Shoulder and Elbow Surgeons Rating Scale, Pennsylvania Shoulder Score, the Simple Shoulder Test, and the Acromioclavicular Joint Separation Questionnaire. Preoperative and postoperative radiographs were compared.


RESULTS
Range of motion measurements were normal in all motions except a loss of 5 degrees +/- 4 degrees (P < .05) in extension. No significant strength deficits were found. Functional closed kinetic chain tests scored comparatively to standardized norms. American Shoulder and Elbow Surgeons Rating scores were 96 +/- 5 out of 100; the Pennsylvania Shoulder Scale scores were 97 +/- 3 out of 100; the Simple Shoulder Test scores were 11.6 +/- 0 out of 12; and Acromioclavicular Joint Separation Questionnaire scores were 28 +/- 3 out of 31. Subjects reported an overall subjective satisfaction of 89% +/- 7%. Postoperative radiographs showed no loss of reduction of the acromioclavicular joint in any patient.


CONCLUSIONS
Outcome for coracoclavicular ligament reconstructions using augmented semitendinosus tendon grafts was excellent with full recovery of strength, minimal range of motion loss, and no clinical or radiographic loss of reduction of the acromioclavicular joint.


CONCLUSIONS
This procedure provides an excellent treatment for grade V acromioclavicular separations.
Nicholas
Stephen J
SJ
Nicholas Institute of Sports Medicine & Athletic Trauma (NISMAT Lenox Hill Hospital, 130 E. 77th Street, New York, NY 10021, USA.
Lee
Steven J
SJ
Mullaney
Michael J
MJ
Tyler
Timothy F
TF
McHugh
Malachy P
MP
D000173:Acromioclavicular Joint / Q000293:injuries* / Q000601:surgery*; D000328:Adult; D001696:Biomechanical Phenomena; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D016059:Range of Motion, Articular; D019651:Plastic Surgery Procedures / Q000379:methods*; D011795:Surveys and Questionnaires; D014184:Transplantation, Homologous; D016896:Treatment Outcome