Author(s)

Lye Hock Tan¹, Salleh Sazali¹, Mohd Rofi Mohd Hafiz Syazwan², Zhuang Li Lim¹, Abdullah Mohd Firdaus¹, Khalid Khairullina¹

¹Sports Clinic, Department of Orthopaedics and Trauma Surgery, Tengku Ampuan Afzan Hospital, Kuantan, Malaysia.
²Sports Clinic, Department of Orthopaedics and Trauma Surgery, Sultanah Nur Zahirah Hospital, Kuala Terengganu, Malaysia.

Introduction: Acromioclavicular (AC) joint separation is regarded as a common shoulder girdle injury that disrupts the anatomical and functional linkage between the upper extremity and the trunk. Various surgical techniques have been developed to treat high-grade AC joint disruption, with convincing clinical outcomes. There are numerous complications that need to be aware of and reduced to ensure consistent positive treatment results. Methods: This was a retrospective report of 6 cases (5 male; 1 female; mean age 25.7 years) of arthroscopically assisted AC joint and coracoclavicular (CC) ligaments anatomical reconstruction for chronic high-grade (Rockwood type IIIB - V) AC joint injury. Patient-reported clinical outcomes and complications encountered were acknowledged and highlighted. The average time from injury to surgery was 194.3 days. Results: The American shoulder and elbow surgeons (ASES) score for the 6 patients increased with a median of 36 at pre-operative to 77.5 at 6 months post-operative and 92.5 at final follow-up. The Visual Analogue Scale, VAS for pain showed improvements from the median of 5.5 at pre-operative to 3.0 at 6 months post-operative and 1.0 at final follow-up. Three patients had tolerable shoulder discomfort post-operatively. Two clavicle tunnels widening (cTW) were detected. One patient presented with loss of reduction (LOR). No infection was encountered post-operatively. All the patients regained full shoulder range of motion post-operatively. No concomitant intraarticular pathology was detected during surgeries. Conclusion: Arthroscopically assisted AC joint and CC ligament anatomical reconstruction with biological graft is a feasible and promising technique to treat chronic AC joint separations. This minimally invasive approach enables accurate implant and graft placement and reduces soft tissue disturbance to the minimum.

Acromioclavicular Joint Separations, Coracoclavicular Ligaments, Arthroscopic Assisted, Chronic High-Grade Rockwood

Tan, L.H., Sazali, S., Syazwan, M.R.M.H., Lim, Z.L., Mohd Firdaus, A. and Khairullina, K. (2025) A Case Series of Arthroscopically Assisted Anatomical Coracoclavicular Ligaments and Acromioclavicular Joint Reconstruction in Chronic High-Grade Acromioclavicular Joint Separations. Journal of Biosciences and Medicines, 13, 300-319. doi: 10.4236/jbm.2025.134025.