{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T02:23:56Z","timestamp":1789957436340,"version":"4.0.1"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,11,29]],"date-time":"2021-11-29T00:00:00Z","timestamp":1638144000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2021,11,29]],"date-time":"2021-11-29T00:00:00Z","timestamp":1638144000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2021,11,29]],"date-time":"2021-11-29T00:00:00Z","timestamp":1638144000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Optimal treatment of chronic unstable acromioclavicular (AC) joint dislocations (stage 3\u20135 according the Rockwood classification) is still debated. Anatomic coracoclavicular (CC) reconstruction is a reliable option in terms of two\u2010dimensional radiographic reduction, clinical outcomes, and return to sports, but there remain concerns regarding anterior\u2013posterior stability of the AC joint with CC ligament reconstruction alone. The aim of the present study was to describe the mid\u2010term results of a new hybrid technique with CC and AC ligament reconstruction for chronic AC joint dislocations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty\u2010two patients surgically treated for chronic AC joint dislocations (grade 3 to 5) were retrospectively reviewed. All patients were assessed before surgery and at final follow\u2010up with the Constant\u2013Murley score (CMS) and the American Shoulder and Elbow Surgeons (ASES) score. The CC vertical distance (CCD) and the CCD ratio (affected side compared to unaffected side) were measured on Zanca radiographs preoperatively, at 6\u00a0months postop and at final follow\u2010up. The same surgical technique consisting in a primary fixation with a suspensory system, coracoclavicular ligaments reconstruction with a double loop of autologous gracilis and acromioclavicular ligaments reconstruction with autologous coracoacromial ligament was performed in all cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010two shoulders in 22 patients (19\u00a0males and 3 females) were evaluated with a mean age of 34.4\u2009\u00b1\u20099 years at the time of surgery. The mean interval between the injury and surgery was 53.4\u2009\u00b1\u200936.7\u00a0days. The mean duration of postoperative follow\u2010up was 49.9\u2009\u00b1\u200911.8\u00a0months. According to the Rockwood classification, there were 5 (22.6%) type\u2010III and 17 (77.2%) type\u2010V dislocations. Mean preoperative ASES and CMS were 54.4\u2009\u00b1\u20097.6 and 64.6\u2009\u00b1\u20097.2, respectively. They improved to 91.8\u2009\u00b1\u20092.3 (p\u2009=\u20090.0001) and 95.2\u2009\u00b1\u20093.1 (p\u2009=\u20090.0001), respectively at final FU. The mean preoperative CCD was 22.4\u2009\u00b1\u20093.2\u00a0mm while the mean CCD ratio was 2.1\u2009\u00b1\u20090.1. At final FU, the mean CCD was 11.9\u2009\u00b1\u20091.4\u00a0mm (p\u2009=\u20090.002) and the mean CCD ratio was 1.1\u2009\u00b1\u20090.1 (p\u2009=\u20090.009). No recurrence of instability was observed. One patient developed a local infection and four patients referred some shoulder discomfort. Heterotopic ossifications were observed in three patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The optimal treatment of chronic high\u2010grade AC joint dislocations requires superior\u2013inferior and anterior\u2013posterior stability to ensure good clinical outcomes and return to overhead activities or sports. The present hybrid technique of AC and CC ligaments reconstruction showed good clinical and radiographic results and is a reliable an alternative to other reported techniques.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Level IV.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-021-06790-7","type":"journal-article","created":{"date-parts":[[2021,11,28]],"date-time":"2021-11-28T22:02:40Z","timestamp":1638136960000},"page":"2084-2091","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Hybrid coracoclavicular and acromioclavicular reconstruction in chronic acromioclavicular joint dislocations yields good functional and radiographic results"],"prefix":"10.1002","volume":"30","author":[{"given":"Simone","family":"Cerciello","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> A. Gemelli University Hospital Foundation IRCCS Catholic University Rome Italy"},{"name":"<!--<label>2<\/label>--> Marrelli Hospital Crotone Italy"},{"name":"<!--<label>3<\/label>--> Casa Di Cura Villa Betania Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7894-1789","authenticated-orcid":false,"given":"Katia","family":"Corona","sequence":"additional","affiliation":[{"name":"<!--<label>4<\/label>--> Department of Medicine and Health Sciences \u201cVincenzo Tiberio\u201d University of Molise Campobasso Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brent Joseph","family":"Morris","sequence":"additional","affiliation":[{"name":"<!--<label>5<\/label>--> Baptist Health Medical Group Orthopedics and Sports Medicine Lexington KY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Proietti","sequence":"additional","affiliation":[{"name":"<!--<label>3<\/label>--> Casa Di Cura Villa Betania Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Mercurio","sequence":"additional","affiliation":[{"name":"<!--<label>6<\/label>--> Department of Orthopaedic and Trauma Surgery Magna Gr\u00e6cia\u201d University, Mater Domini\u201d University Hospital Catanzaro Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Cattaneo","sequence":"additional","affiliation":[{"name":"<!--<label>7<\/label>--> Department of Bone and Joint Surgery Spedali Civili Brescia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Milano","sequence":"additional","affiliation":[{"name":"<!--<label>7<\/label>--> Department of Bone and Joint Surgery Spedali Civili Brescia 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