title: Palmaris longus tendon graft versus modified Weaver-Dunn procedure via dynamic button system for acromioclavicular joint reconstruction in chronic cases.
abstract: BACKGROUND
  The hypothesis of this clinical study was that coracoclavicular (CC) reconstruction using autogenic palmaris longus graft through the GraftRope (PLG) system (Arthrex, Inc., Naples, FL, USA) would provide superior clinical and radiologic results compared with modified Weaver-Dunn procedure with the dynamic TightRope (Arthrex, Inc.) system (WDT).
  
  
  METHODS
  Between 2008 and 2013, 32 patients (average age, 39.7 years; range, 22-60 years) underwent surgical reconstruction of chronic acromioclavicular (AC) joint dislocation. A modified WDT procedure was performed in 16 patients and autogenous PLG was performed in the other 16 patients. Patient data were collected retrospectively, with a final follow-up of 44.9 months (range, 29-60 months). The degree of AC joint displacement was evaluated by measuring the CC distance on the anteroposterior and axillary view. Clinical and functional outcomes were compared by American Shoulder and Elbow Surgeons and the Constant scores at final follow-up.
  
  
  RESULTS
  Comparison between the WDT and PLG groups showed a significantly better outcome in the American Shoulder and Elbow Surgeons and the Constant scores (P < .01), in favor of the PLG group. Both groups showed an increased CC distance compared with the uninjured side, with a mean difference of 1.1 mm for the PLG and 3.3 mm for the WDT groups. A tolerable loss of reduction within the follow-up time was observed. Reduction loss was higher with the WDT group (P < .05).
  
  
  CONCLUSIONS
  CC palmaris longus tendon graft reconstruction with GraftRope system was associated with functional and radiologic benefits. The palmaris longus graft with GraftRope system could be used in chronic cases.
authors.affiliation: Department of Orthopedic Surgery, Acibadem University Faculty of Medicine, Istanbul, Turkey. Electronic address: bariskocaoglu@gmail.com.
authors.forename: Baris
authors.initials: B
authors.lastname: Kocaoglu
authors.affiliation: Department of Orthopedic Surgery, Acibadem University Faculty of Medicine, Istanbul, Turkey.
authors.forename: Tekin Kerem
authors.initials: TK
authors.lastname: Ulku
authors.affiliation: Department of Orthopedic Surgery, Acibadem University Faculty of Medicine, Istanbul, Turkey.
authors.forename: Arel
authors.initials: A
authors.lastname: Gereli
authors.affiliation: Department of Orthopedic Surgery, Acibadem University Faculty of Medicine, Istanbul, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Karahan
authors.affiliation: Department of Orthopedic Surgery, Acibadem University Faculty of Medicine, Istanbul, Turkey.
authors.forename: Metin
authors.initials: M
authors.lastname: Türkmen
mesh_terms: D000173:Acromioclavicular Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D000328:Adult; D019643:Arthroplasty, Replacement; D002968:Clavicle / Q000000981:diagnostic imaging; D000070597:Coracoid Process / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000295:instrumentation / Q000379:methods*; D012189:Retrospective Studies; D012783:Shoulder Dislocation / Q000601:surgery; D013710:Tendons / Q000637:transplantation*; D055815:Young Adult
keywords: AC joint; Weaver-Dunn; button system; chronic; dislocation; graft; palmaris longus; reconstruction