Chronic acromioclavicular separation: The medium term results of coracoclavicular ligament reconstruction using braided polyester prosthetic ligament

SummaryIn this series, we treated chronic acromioclavicular disruption with an artificial coraco-clavicular ligament made from braided polyester (The Nottingham Surgilig). The ligament has a loop at each end and is passed around the coracoid process, threaded through itself, then passed around the posterior aspect of the clavicle and finally anchored to it with a bone screw.Eleven men with an average age of 39 underwent this procedure. Three patients had previously been operated on using the Weaver–Dunn procedure which had failed. All eleven patients have been reassessed clinically and radiographically at an average of 55 months. Using the Imatani evaluation score, 10 patients achieved a good/excellent result with the mean Constant score being 92. One patient had fracture of the base of the coracoid after heavy lifting in the early postoperative period which resulted in a poor outcome. Two patients needed an additional operation. In one the lateral end of the clavicle was excised together with removal of the fixation screw, and in the other a subacromial decompression was carried out.The Nottingham Surgilig is a useful alternative for the treatment of chronic acromioclavicular separation, especially in revision reconstruction when the coracoacromial ligament is no longer available.