Type III Acromioclavicular Separation: Rationale for Anatomical Reconstruction
Adam J. Farber, MD, Brett M. Cascio, MD, and John H. Wilckens, MD
At the time of the study, Dr. Farber was a Chief Resident, Dr. Cascio was a Chief Resident, and Dr. Wilckens was Chairman at JHBMC, Department of Orthopaedic Surgery, Johns Hopkins University/Johns Hopkins Bayview Medical Center, Baltimore, Maryland.
Treatment of acute type III acromioclavicular separation is controversial. In some patients, nonoperative treatment is associated with pain, weakness, and stiffness. Many acromioclavicular joint reconstructions are associated with complications and results not substantially better than those of nonoperative treatment. Use of autogenous free tendon graft to anatomically reconstruct the acromioclavicular and coracoclavicular ligaments offers several advantages over other surgical techniques. These advantages include improved biomechanical properties, no foreign body implantation, biological fixation, anatomical reconstruction, and early rehabilitation.