RESUMEN
BACKGROUND: Acromioclavicular joint separations continue to be a challenge for surgeons, and modern arthroscopically assisted techniques are becoming increasingly widespread. The aim of this study is to evaluate if the use of a biological support in association with a nonresorbable subcoracoid fixation can improve long-term stability in acromioclavicular joint dislocation surgically treated. We assessed clinical and radiographic results, patients' return to daily activities and the risk of complications. MATERIALS AND METHODS: Fourteen patients underwent subcoracoid fixation with the GraftRope system for chronic Rockwood type IV acromioclavicular joint dislocation. A total of 12 patients were evaluated clinically and radiologically with a minimum of 7 years of follow-up. RESULTS: Good reduction was obtained in all patients. All patients returned to work and sports at the pretrauma level with high mean scores on clinical evaluation. Regarding complications, 3 patients developed acromioclavicular arthritis. Ossifications were a common finding on x-rays, but they did not worsen the clinical outcome. CONCLUSIONS: The GraftRope surgical technique allows us to obtain an anatomical reduction of the acromio-clavicular joint, along with the restoration of the mechanical properties of the joint, owing to the use of a biological material with rigidity and load resistance features. Clinical results over the long term are encouraging. However, a 6-mm bone tunnel is too large since the average thickness of the coracoid process is only approximately 12 mm. This technique has some advantages over others: it avoids detachment of the deltoid, avoids the use of bulky metal implants with an important dissection of soft tissue, while it has all the advantages of an arthroscopic procedure.
