{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T20:02:45Z","timestamp":1781726565909,"version":"3.54.5"},"reference-count":33,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2009,12,31]],"date-time":"2009-12-31T00:00:00Z","timestamp":1262217600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2009,12,31]],"date-time":"2009-12-31T00:00:00Z","timestamp":1262217600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2009,12,31]],"date-time":"2009-12-31T00:00:00Z","timestamp":1262217600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2009,12,31]],"date-time":"2009-12-31T00:00:00Z","timestamp":1262217600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"}],"content-domain":{"domain":["arthroscopyjournal.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy"],"published-print":{"date-parts":[[2010,2]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>We described a novel all\u2010arthroscopic technique of coracoclavicular ligament reconstruction and reported the early clinical and radiologic results of this procedure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed all\u2010arthroscopic coracoclavicular ligament reconstruction in 10 consecutive patients (8 men and 2 women; mean age, 41 years) with a symptomatic chronic and complete acromioclavicular (AC) joint dislocation (Rockwood type III or IV). Four patients had undergone surgery previously: two had initial pinning of the acute AC joint separation, and two had a subsequent Mumford procedure. The surgical technique, performed entirely by arthroscopy, consisted of (1) rerouting the coracoacromial ligament with a bone block harvested from the tip of the acromion in a socket created in the distal clavicle (Chuinard's modification of the Weaver\u2010Dunn procedure) and (2) augmenting the reconstruction with 2 titanium buttons connected by a heavy suture in a 4\u2010strand configuration (Double\u2010Button fixation; Smith &amp; Nephew Endoscopy, Andover, MA). Patients were prospectively followed up for a mean of 12.8 months (range, 6 to 20 months).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      One patient had a superficial infection of the superior (clavicular) portal, which resolved with oral antibiotics. At the most recent review, all patients were satisfied or very satisfied with the cosmesis, and 9 of 10 returned to previous sports, including contact and overhead sports. All symptoms resolved (pain, shoulder weakness, paresthesia). The mean postoperative University of California, Los Angeles modified AC rating score was 16.5 points (range, 13 to 18 points) out of 20 points. The mean Subjective Shoulder Value improved from 36% (range, 0% to 70%) preoperatively to 82.5% (range, 70% to 100%) postoperatively (\n                      <jats:italic>P<\/jats:italic>\n                      = .005). The bone block was totally healed in the medullary canal in 8 cases and partially healed in 2. No loss of reduction was observed in any of the patients.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our study shows that severe chronic symptomatic AC joint separations, defined as Rockwood types III through V, can be repaired entirely by arthroscopy safely and effectively by transferring the coracoacromial ligament with a bone block in the distal clavicle. The bone block transfer (Weaver\u2010Dunn\u2010Chuinard procedure) has the advantage of making the repair easier and stronger, and it provides bone\u2010to\u2010bone healing by use of free, autologous vascularized tissue. Double\u2010Button fixation has the advantage of maintaining the reduction during the biological healing process. Although the durability of the reconstruction remains unproven, in our short\u2010term follow\u2010up we observed no loss of reduction and the functional and cosmetic results were uniformly good.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level IV, therapeutic case series.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2009.08.008","type":"journal-article","created":{"date-parts":[[2009,12,31]],"date-time":"2009-12-31T04:07:52Z","timestamp":1262232472000},"page":"149-160","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":113,"title":["All\u2010Arthroscopic Weaver\u2010Dunn\u2010Chuinard Procedure With Double\u2010Button Fixation for Chronic Acromioclavicular Joint Dislocation"],"prefix":"10.1002","volume":"26","author":[{"given":"Pascal","family":"Boileau","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery and Sports Traumatology L'Archet Hospital University of Nice\u2010Sophia\u2010Antipolis Nice France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason","family":"Old","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Sports Traumatology L'Archet Hospital University of Nice\u2010Sophia\u2010Antipolis Nice France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Gastaud","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Sports Traumatology L'Archet Hospital University of Nice\u2010Sophia\u2010Antipolis Nice France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Brassart","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Sports Traumatology L'Archet Hospital University of Nice\u2010Sophia\u2010Antipolis Nice France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yannick","family":"Roussanne","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Sports Traumatology L'Archet Hospital University of Nice\u2010Sophia\u2010Antipolis Nice France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2009,12,31]]},"reference":[{"key":"e_1_2_2_2_1","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-198668030-00019"},{"key":"e_1_2_2_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1058-2746(99)90003-4"},{"key":"e_1_2_2_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546505281795"},{"key":"e_1_2_2_5_1","first-page":"52","volume-title":"The shoulder","author":"Codman 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