{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:47:57Z","timestamp":1787755677816,"version":"build-2784847793"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JBJS Essential Surgical Techniques"],"published-print":{"date-parts":[[2017,3,8]]},"abstract":"<jats:p>Acute acromioclavicular (AC)-joint dislocations are common injuries of the shoulder girdle. Surgical repair is indicated for acute high-grade (Rockwood types IV, V, and VI) AC-joint injuries. The best treatment for type III is still controversial, but young and active patients with this type of injury might benefit from a surgical AC-joint stabilization. Surgery should be performed within the first 3 weeks after the injury since the biological healing potential decreases with time. Acute AC-joint separation is diagnosed by clinical examination and radiography. Vertical translation anteroposterior stress views with a 10-kg load are used to grade the injuries. Bilateral lateral stress (Alexander) views are used to evaluate dynamic horizontal translation qualitatively.<\/jats:p>\n                  <jats:p>Arthroscopic techniques for AC reconstruction have become more popular in recent years because they are minimally invasive; they allow treatment of concomitant glenohumeral lesions; and they can be performed in one step, with insertion of implants that do not have to be removed later. The arthroscopically assisted double-button technique with an additional AC cerclage was developed to stabilize the AC joint by internal bracing of the torn ligaments.<\/jats:p>\n                  <jats:p>The procedure consists of the following steps. Step 1: With the patient in the beach-chair position, a 2-cm incision is made on top of the clavicle and posterior and lateral viewing portals as well as an anteroinferior working portal are created. Step 2: With the arthroscope in the lateral portal, the subcoracoid bursa and the base of the coracoid are dissected with a radiofrequency ablation device through the anteroinferior portal. Step 3: Coracoclavicular drilling is done with use of a drill guide and under arthroscopic and image-intensifier control. After overdrilling of the Kirschner wires, Nitinol suture passers are introduced and retrieved via the anteroinferior portal. Step 4: Transclavicular and transacromial drill-holes are established for the AC cerclage. Step 5: The 2 double-button devices are attached to the Nitinol suture passers, and the inferior buttons are shuttled through the clavicle and coracoid and then placed parallel to the coracoid base. Step 6: The sutures are tightened, and an anatomical vertical reduction of the AC joint is achieved. Step 7: A triangular acromioclavicular nonabsorbable cerclage tape is used for horizontal stabilization. Step 8: The clavicular incision is closed in 2 layers, including the repair of the deltotrapezoidal fascia and the arthroscopic portals, in a standard fashion.<\/jats:p>\n                  <jats:p>The combined arthroscopically-assisted and image-intensifier-controlled double-button technique with an additional AC cerclage is a safe procedure that enables an anatomical reduction of the AC joint and yields good to excellent clinical results.<\/jats:p>","DOI":"10.2106\/jbjs.st.16.00063","type":"journal-article","created":{"date-parts":[[2017,2,25]],"date-time":"2017-02-25T16:52:07Z","timestamp":1488041527000},"page":"e7","source":"Crossref","is-referenced-by-count":7,"title":["Arthroscopic Reconstruction After Acute Acromioclavicular Separation Injuries"],"prefix":"10.2106","volume":"7","author":[{"given":"Marvin","family":"Minkus","sequence":"first","affiliation":[{"name":"Department of Shoulder and Elbow Surgery, Center for Musculoskeletal Surgery, Charit\u00e9-Universitaetsmedizin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natascha","family":"Kraus","sequence":"additional","affiliation":[{"name":"Department of Shoulder and Elbow Surgery, Center for Musculoskeletal Surgery, Charit\u00e9-Universitaetsmedizin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Hann","sequence":"additional","affiliation":[{"name":"Department of Shoulder and Elbow Surgery, Center for Musculoskeletal Surgery, Charit\u00e9-Universitaetsmedizin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Scheibel","sequence":"additional","affiliation":[{"name":"Department of Shoulder and Elbow Surgery, Center for Musculoskeletal Surgery, Charit\u00e9-Universitaetsmedizin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"2","key":"bib1-20230812","first-page":"34","article-title":"Radiography of the acromioclavicular articulation","volume":"30","author":"Alexander","year":"1954","journal-title":"Med Radiogr Photogr."},{"key":"bib2-20230812","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1097\/00003086-198701000-00023","article-title":"A clinical method of functional assessment of the shoulder","volume":"214","author":"Constant","year":"1987","journal-title":"Clin Orthop Relat Res."},{"issue":"6","key":"bib3-20230812","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1016\/j.jse.2007.02.123","article-title":"Comparison of the subjective shoulder value and the Constant score","volume":"16","author":"Gilbart","year":"2007","journal-title":"J Shoulder Elbow Surg."},{"issue":"2","key":"bib4-20230812","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1007\/s00113-011-2065-z","article-title":"[Arthroscopically assisted stabilization of acute injury to the acromioclavicular joint with the double TightRope\u2122 technique: one-year results]","volume":"116","author":"Gerhardt","year":"2013","journal-title":"Unfallchirurg."},{"issue":"8","key":"bib6-20230812","first-page":"556","article-title":"[Management of old neglected posttraumatic acromioclavicular joint instability and arthrosis]","volume":"27","author":"Hedtmann","year":"1998","journal-title":"Orthopade."},{"issue":"2","key":"bib7-20230812","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1007\/s00167-012-2270-5","article-title":"Has the arthroscopically assisted reduction of acute AC joint separations with the double Tight-Rope technique advantages over the clavicular hook plate fixation?","volume":"22","author":"Jensen","year":"2014","journal-title":"Knee Surg Sports Traumatol Arthrosc."},{"issue":"10","key":"bib8-20230812","doi-asserted-by":"crossref","first-page":"1431","DOI":"10.1007\/s00402-013-1804-8","article-title":"Arthroscopically assisted stabilization of acute high-grade acromioclavicular joint separations in a coracoclavicular double-TightRope technique: V-shaped versus parallel drill hole orientation","volume":"133","author":"Kraus","year":"2013","journal-title":"Arch Orthop Trauma Surg."},{"issue":"10","key":"bib9-20230812","doi-asserted-by":"crossref","first-page":"872","DOI":"10.1007\/s00113-012-2248-2","article-title":"[Treatment of acute acromioclavicular joint instability with modern reconstruction procedures]","volume":"115","author":"Kraus","year":"2012","journal-title":"Unfallchirurg."},{"issue":"6","key":"bib10-20230812","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1016\/j.jse.2012.08.016","article-title":"Prevalence and pattern of glenohumeral injuries among acute high-grade acromioclavicular joint instabilities","volume":"22","author":"Pauly","year":"2013","journal-title":"J Shoulder Elbow Surg."},{"issue":"7","key":"bib12-20230812","doi-asserted-by":"crossref","first-page":"1507","DOI":"10.1177\/0363546511399379","article-title":"Arthroscopically assisted stabilization of acute high-grade acromioclavicular joint separations","volume":"39","author":"Scheibel","year":"2011","journal-title":"Am J Sports Med."},{"issue":"7","key":"bib13-20230812","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.2106\/00004623-198769070-00013","article-title":"Dislocation of the acromioclavicular joint. An end-result study","volume":"69","author":"Taft","year":"1987","journal-title":"J Bone Joint Surg Am."},{"issue":"3","key":"bib14-20230812","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1177\/0363546512473438","article-title":"Arthroscopically assisted 2-bundle anatomic reduction of acute acromioclavicular joint separations: 58-month findings","volume":"41","author":"Venjakob","year":"2013","journal-title":"Am J Sports Med."}],"container-title":["JBJS Essential Surgical Techniques"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/01709766-201707010-00007","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:47:35Z","timestamp":1787752055000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/01709766-201707010-00007"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,3,8]]},"references-count":12,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2017]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.st.16.00063","relation":{},"ISSN":["2160-2204"],"issn-type":[{"value":"2160-2204","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,3,8]]}}}