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What is being presented is the long\u2010term functional outcomes of a double cross\u2010looped coracoclavicular (CC) suture technique with the intention of restoring both anteroposterior and superior displacement of the clavicle.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between 2007 and 2016, 81 patients underwent surgical reconstruction for acute acromioclavicular joint (AC) disruption in two orthopaedic centers. Two patients died for reasons unrelated to the treatment, and seven missed the final follow\u2010up appointment, leaving 72 patients (67\u00a0males; 5 females; age 37\u2009\u00b1\u200912.4; range 15\u201364 years) for clinical and radiological assessments. All cases were classified according to the Rockwood classification as type III (<jats:italic>n<\/jats:italic>\u2009=\u200934), IV (<jats:italic>n<\/jats:italic>\u2009=\u200914) or V (<jats:italic>n<\/jats:italic>\u2009=\u200924). The dislocation was repaired with double cross\u2010looped CC fixation using four Ethibond sutures passing underneath the coracoid and through a 4.5\u00a0mm drill hole in the clavicle in opposing directions to control both anteroposterior and vertical displacement. Radiological investigation preoperatively and at the last follow\u2010up included anteroposterior and\/or Zanca views, axillary or Alexander views, and comparative stress radiography of both AC joints. Patients were evaluated clinically with the Constant\u2010Murley score (CMS) and Acromio Clavicular Joint Instability Score (ACJIS). Loss of reduction, subluxation, CC ligament ossification, post\u2010traumatic arthritis, and peri\u2010implant fractures were also recorded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventy\u2010two patients were available for the last clinical and radiological evaluations. At a median follow\u2010up period of 6.3\u2009\u00b1\u20092.1 years (range 3\u201312 years), the CMS and ACJIS were 92.1\u2009\u00b1\u20097.2 (range 60\u2013100 points) and 90.4\u2009\u00b1\u20098.6 (range 45\u2013100 points), respectively. Complications included 9 (12.5%) patients with slight loss of reduction, 2 (1.7%) with dislocation recurrence, 1 (1.3%) with superficial infection, 1 (1.3%) with a fracture of the lateral end of the clavicle, and 2 (1.7%) with persistent tenderness in the AC joint. The incidence of periarticular ossification was 22.4% and did not affect the final outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This technique represents an effective and low\u2010cost treatment for acute AC joint separations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>IV.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-020-06158-3","type":"journal-article","created":{"date-parts":[[2020,7,20]],"date-time":"2020-07-20T08:04:21Z","timestamp":1595232261000},"page":"2103-2109","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Long\u2010term stability of coracoclavicular suture fixation for acute acromioclavicular joint separation"],"prefix":"10.1002","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8215-9327","authenticated-orcid":false,"given":"A.","family":"Panagopoulos","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Shoulder and Elbow Surgery Patras University Hospital Papanikolaou 1 26504 Patras Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Fandridis","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Hand Surgery\u2010Upper Limb and Microsurgery Department General Hospital \u201cKAT\u201d Athens Kifissia Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G. Delle","family":"Rose","sequence":"additional","affiliation":[{"name":"<!--<label>4<\/label>--> Humanitas Clinical and Research Center \u2010 IRCCS Via Manzoni 56 20089 Rozzano Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Ranieri","sequence":"additional","affiliation":[{"name":"<!--<label>3<\/label>--> Department of Biomedical Sciences Humanitas University Via Manzoni 56 20089 Rozzano Pieve Emanuele\u2010Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Castagna","sequence":"additional","affiliation":[{"name":"<!--<label>3<\/label>--> Department of Biomedical Sciences Humanitas University Via Manzoni 56 20089 Rozzano Pieve Emanuele\u2010Milan Italy"},{"name":"<!--<label>4<\/label>--> Humanitas Clinical and Research Center \u2010 IRCCS Via Manzoni 56 20089 Rozzano Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Z. 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