New GraftRope Reconstruction of AC Dislocation

September 3rd, 2008

Most Grade 3 AC dislocations are treated without surgery, but 20% or so of patients may have chronic pain and stiffness. Historically, a plethora of options have existed--all performed via large incisions, and none without eventual failure in a high percentage.

A new device commercialized by Arthrex Inc in 2008--The AC GraftRope System-- includes a tendon allograft and heavy suture construct. The procedure is a natural evolution from use of the suture alone for acute dislocations--not older than 2 months, and the Mazzocca technique using allograft and the "tightrope" for chronic dislocations.

Although an open technique is more common, it is feasible to perform this procedure arthroscopically--except for a small 3 cm incision on top of the clavicle. If the AC joint is reducible, a distal clavicle excision may not be necessary. I demonstrate the Arthroscopic technique in the videos below.

Related Photos:

The GraftRope suture/allograft construct

Postoperative x-ray after GraftRope procedure

Related Videos:

1. coracoid is exposed

2. guide wire is passed through the clavicle and coracoid

3. reamer is passed over the guidewire

4. wire suture passer is passed

5. sutures are passed

6. metal button passed

7. button flipped inferior to the coracoid base

8. finished GraftRope reconstruction

9. 3 month outcome