Double Endobutton Technique for Repair of Complete Acromioclavicular Joint Dislocations

A gold standard for the reconstruction of the coracoclavicular complex has yet to emerge for the treatment of separation of the acromioclavicular joint. Most of the current techniques not only fail to recreate the original anatomy, but also do not use materials that are strong enough to maintain the reduction during the healing process. Using a weak and nonanatomical construct has predictably led to problems with slippage of the initial reduction, as well as implant-related complications. This report introduces a novel technique for the reconstruction of complete acromioclavicular joint separation by using an Endobutton CL that has been modified for use in the shoulder. The device is placed through holes in the coracoid and clavicle reproducing the course of the conoid portion of the coracoclavicular ligament. The Endobutton CL material has been shown to have both strength and stiffness in excess of the native anatomy, ensuring a stable reduction. The procedure is simple, has low morbidity, and can be easily adapted to an arthroscopic technique.