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For more severe or unstable separations (Rockwood types IIIB, IV, V, and VI), surgical intervention is typically recommended. Over 160 surgical techniques have been described, but none have emerged as a gold standard. Arthroscopic\u2010assisted or all\u2010arthroscopic fixation of the coracoclavicular ligaments with suture buttons has become increasingly popular due to lower complication rates compared with more rigid fixation. Configurations include single\u2010bundle (SB) constructs and double\u2010bundle (DB) configurations that more anatomically reconstruct the conoid and trapezoid ligaments but with longer operative times. Clinical studies with short\u2010term follow\u2010up have demonstrated improved maintenance of fixation for DB compared with SB constructs but no significant differences in clinical outcomes. In our experience, SB suture button\u2013only constructs lead to unacceptable failures due to loss of reduction. We recommend either a single suture button construct augmented with allograft or DB suture button constructs for the treatment of acute AC joint separations.<\/jats:p>","DOI":"10.1016\/j.arthro.2024.04.014","type":"journal-article","created":{"date-parts":[[2024,4,30]],"date-time":"2024-04-30T05:01:25Z","timestamp":1714453285000},"page":"2798-2800","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":4,"title":["<i>Editorial Commentary:<\/i>\n                    Acromioclavicular Joint Reconstruction With Double\u2010Bundle Constructs Provides Improved Maintenance of Reduction but Comparable Clinical Outcomes Versus Single\u2010Bundle Constructs"],"prefix":"10.1002","volume":"40","author":[{"given":"Michelle","family":"Xiao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey D.","family":"Abrams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,4,29]]},"reference":[{"key":"e_1_2_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2013.11.005"},{"key":"e_1_2_3_3_2","doi-asserted-by":"publisher","DOI":"10.5435\/JAAOS-D-17-00105"},{"key":"e_1_2_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2012.11.023"},{"key":"e_1_2_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2018.01.016"},{"key":"e_1_2_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2018.06.048"},{"key":"e_1_2_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2020.10.002"},{"key":"e_1_2_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2022.09.018"},{"key":"e_1_2_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2024.03.031"},{"key":"e_1_2_3_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12178-014-9255-6"}],"container-title":["Arthroscopy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0749806324002998?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0749806324002998?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.arthro.2024.04.014","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1016\/j.arthro.2024.04.014","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.arthro.2024.04.014","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T09:12:06Z","timestamp":1773565926000},"score":1,"resource":{"primary":{"URL":"https:\/\/arthroscopyjournals.onlinelibrary.wiley.com\/doi\/10.1016\/j.arthro.2024.04.014"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,29]]},"references-count":9,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1016\/j.arthro.2024.04.014"],"URL":"https:\/\/doi.org\/10.1016\/j.arthro.2024.04.014","archive":["Portico"],"relation":{},"ISSN":["0749-8063","1526-3231"],"issn-type":[{"value":"0749-8063","type":"print"},{"value":"1526-3231","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,29]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Editorial Commentary: Acromioclavicular Joint Reconstruction With Double-Bundle Constructs Provides Improved Maintenance of Reduction but Comparable Clinical Outcomes Versus Single-Bundle Constructs","name":"articletitle","label":"Article Title"},{"value":"Arthroscopy: The Journal of Arthroscopic & Related Surgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.arthro.2024.04.014","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"https:\/\/doi.org\/10.1016\/j.arthro.2024.03.031","name":"associatedlink","label":"CrossRef DOI link to the associated document"},{"value":"simple-article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2024 by the Arthroscopy Association of North America","name":"copyright","label":"Copyright"}]}}