Arthroscopic treatment of chronic acromioclavicular joint dislocation by modified Weaver-Dunn techinique [Trattamento artroscopico delle lussazioni croniche dell’articolazione acromion-claveare mediante tecnica di Weaver-Dunn modificata]

The authors describe an arthroscopic reconstruction technique for type III, IV and V acromioclavicular symptomatic chronic joint dislocation. It consists of a closed reduction and transfer of the acromial attachment of the coracoacromial ligament to the resected surface of the distal clavicle, associated to the positioning of a cannulated screw between the clavicle and the coracoid under arthroscopic control to achieve greater primary stability. Coracoacromial ligament is secured to the superior surface of clavicle by an Endobutton (Smith and Nephew, Andover, Massachusetts). The resection of the distal clavicle is minimal. The screw is finally removed under local anesthesia 12 weeks after surgery. The described procedure has been performed in three patients. Preliminary results show an excellent functional outcome without any residual pain. Among the advantages of the technique are a minimally invasive approach, the possibility of searching the glenohumeral joint for associated lesions and eventually treating them, and the benefits of not exposing the patient or surgical team to ionizing radiation.