{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T22:02:20Z","timestamp":1790287340876,"version":"4.1.0"},"reference-count":57,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,5,1]],"date-time":"2019-05-01T00:00:00Z","timestamp":1556668800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2019,5,1]],"date-time":"2019-05-01T00:00:00Z","timestamp":1556668800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2019,5,1]],"date-time":"2019-05-01T00:00:00Z","timestamp":1556668800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2019,5,1]],"date-time":"2019-05-01T00:00:00Z","timestamp":1556668800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2018,12,19]],"date-time":"2018-12-19T00:00:00Z","timestamp":1545177600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009026","name":"Smith and Nephew","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009026","id-type":"DOI","asserted-by":"publisher"}]}],"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":[[2019,5]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To report the outcomes of all\u2010arthroscopic coracoclavicular (CC) ligament reconstruction and simultaneous diagnosis and treatment of glenohumeral pathologies in patients with symptomatic, chronic (&gt;6\u00a0weeks), complete (Rockwood type III\u2010V) acromioclavicular joint (ACJ) separations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We prospectively followed up 57 consecutive patients treated arthroscopically for chronic Rockwood type III (n\u00a0= 11), type IV (n\u00a0= 19), and type V (n\u00a0= 27) ACJ dislocations. Previous ACJ surgery failed in 11 (19%). The mean delay between injury and surgery was 39\u00a0months (range, 6\u00a0months to 17\u00a0years). The mean age at surgery was 42\u00a0years (range, 19\u201071\u00a0years). After glenohumeral exploration, an arthroscopic modified Weaver\u2010Dunn procedure with CC suture button fixation (Twinbridge) was performed. The CC reduction and tunnel position were analyzed with radiographs and computed tomography. The mean follow\u2010up period was 36\u00a0months (range, 12\u201072\u00a0months).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Intra\u2010articular pathology was treated arthroscopically in 27 patients (48%): 17 labral tears, 8 rotator cuff tears (3 partial and 5 complete), and 15 biceps lesions (4 SLAP lesions and 11 subluxations). At last follow\u2010up, 7 patients (12%) experienced recurrent ACJ instability: 2 frank dislocations (1 trauma and 1 infection) and 5 ACJ subluxations. There was no significant correlation between subluxation and clinical outcome. The rate of recurrent ACJ instability was significantly higher in patients with higher\u2010grade ACJ dislocations (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .01) and\/or previous failed surgery (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001). Recurrent subluxation was observed in 3 cases of lateral migration of the coracoid button with lateral tunnel placement, as well as 2 cases of anterior migration of the clavicular button with anterior tunnel placement. The Constant score increased from 67 (range, 28\u201089) to 85.5 (range, 66\u2010100), and the mean Subjective Shoulder Value increased from 54% to 85% (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001). At last follow\u2010up, 95% of patients (54 of 57) were satisfied.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>All\u2010arthroscopic treatment allows successful CC ligament reconstruction and simultaneous diagnosis and treatment of frequently associated (48%) glenohumeral lesions. Higher\u2010grade ACJ dislocations, previous ACJ surgery, and misplacement of bone tunnels are risk factors for recurrent instability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level IV, case series.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2018.11.058","type":"journal-article","created":{"date-parts":[[2019,5,1]],"date-time":"2019-05-01T03:07:07Z","timestamp":1556680027000},"page":"1324-1335","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":31,"title":["All\u2010Arthroscopic Reconstruction of Severe Chronic Acromioclavicular Joint Dislocations"],"prefix":"10.1002","volume":"35","author":[{"given":"Pascal","family":"Boileau","sequence":"first","affiliation":[{"name":"iULS (Institut Universitaire Locomoteur et du Sport) H\u00f4pital Pasteur 2 University C\u00f4te d\u2019Azur Nice France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Gastaud","sequence":"additional","affiliation":[{"name":"iULS (Institut Universitaire Locomoteur et du Sport) H\u00f4pital Pasteur 2 University C\u00f4te d\u2019Azur Nice France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Wilson","sequence":"additional","affiliation":[{"name":"iULS (Institut Universitaire Locomoteur et du Sport) H\u00f4pital Pasteur 2 University C\u00f4te d\u2019Azur Nice France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christophe","family":"Trojani","sequence":"additional","affiliation":[{"name":"iULS (Institut Universitaire Locomoteur et du Sport) H\u00f4pital Pasteur 2 University C\u00f4te d\u2019Azur Nice France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Bronsard","sequence":"additional","affiliation":[{"name":"iULS (Institut Universitaire Locomoteur et du Sport) H\u00f4pital Pasteur 2 University C\u00f4te d\u2019Azur Nice France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,5,1]]},"reference":[{"key":"e_1_2_2_2_2","first-page":"11","article-title":"Current concepts in the surgical management of acromioclavicular joint injuries","volume":"70","author":"Epstein D.","year":"2012","journal-title":"Bull NYU Hosp Jt Dis"},{"key":"e_1_2_2_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/03635465980260010801"},{"key":"e_1_2_2_4_2","first-page":"89","article-title":"Type III acromioclavicular separation: Results of a recent survey on its management","volume":"36","author":"Nissen C.W.","year":"2007","journal-title":"Am J Orthop (Belle Mead 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Published by Elsevier on behalf of the Arthroscopy Association of North America.","name":"copyright","label":"Copyright"}]}}