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Purpose <p>Chronic acromioclavicular joint instability (ACJI) remains challenging, and the optimal surgical technique is debated. Weaver–Dunn reconstruction is widely used, but modifications have been made to improve horizontal and vertical stability. This study addressed the clinical outcomes of a modified Weaver–Dunn procedure reinforced with a double EndoButton construct.</p> Methods <p>This retrospective single-center study included 23 patients undergoing modified Weaver–Dunn reconstruction for chronic ACJI between 2012 and 2024, with a minimum follow-up of 12 months. Indications included symptomatic Rockwood grade 3 or higher after failed conservative management. Surgery was performed arthroscopically in most cases; five cases used an open approach. Clinical assessment included Constant–Murley score, Subjective Shoulder Value (SSV), Visual Analog Scale (VAS) for pain, ROM, piano-key sign, and clavicular drawer test. Radiographic evaluation included coracoclavicular distance, alignment, and loss of reduction. Complications and revisions were documented.</p> Results <p>At a mean follow-up of 79 months, pain improved significantly (VAS 2.9 to 0.4, <i>p</i> = 0.001). Constant score increased from 60 to 87 (<i>p</i> = 0.001), and SSV improved significantly. Forward flexion improved from 159° to 175° (<i>p</i> = 0.015), and abduction from 163° to 175° (<i>p</i> = 0.03). Clinical stability improved, with disappearance of the piano-key sign and drawer sign in 82% and 91% of cases. Four patients (17%) showed recurrent grade 3 or higher dislocation. Complications occurred in five patients (22%), including one coracoid fracture and one EndoButton migration.</p> Conclusion <p>Modified Weaver–Dunn reconstruction using two EndoButtons provided significant improvements in pain, function, ROM, and clinical stability with acceptable recurrence and complication rates.</p>

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Chronic acromioclavicular dislocations repaired by modified Weaver-Dunn technique with two EndoButtons: retrospective review of twenty three cases

  • 期刊论文

  • 发表日期：

    2026年4月28日

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  • Alexandra Stein,
  • Efi Kazum,
  • Mohamad Moussa,
  • Philippe Valenti

摘要

Purpose

Chronic acromioclavicular joint instability (ACJI) remains challenging, and the optimal surgical technique is debated. Weaver–Dunn reconstruction is widely used, but modifications have been made to improve horizontal and vertical stability. This study addressed the clinical outcomes of a modified Weaver–Dunn procedure reinforced with a double EndoButton construct.

Methods

This retrospective single-center study included 23 patients undergoing modified Weaver–Dunn reconstruction for chronic ACJI between 2012 and 2024, with a minimum follow-up of 12 months. Indications included symptomatic Rockwood grade 3 or higher after failed conservative management. Surgery was performed arthroscopically in most cases; five cases used an open approach. Clinical assessment included Constant–Murley score, Subjective Shoulder Value (SSV), Visual Analog Scale (VAS) for pain, ROM, piano-key sign, and clavicular drawer test. Radiographic evaluation included coracoclavicular distance, alignment, and loss of reduction. Complications and revisions were documented.

Results

At a mean follow-up of 79 months, pain improved significantly (VAS 2.9 to 0.4, p = 0.001). Constant score increased from 60 to 87 (p = 0.001), and SSV improved significantly. Forward flexion improved from 159° to 175° (p = 0.015), and abduction from 163° to 175° (p = 0.03). Clinical stability improved, with disappearance of the piano-key sign and drawer sign in 82% and 91% of cases. Four patients (17%) showed recurrent grade 3 or higher dislocation. Complications occurred in five patients (22%), including one coracoid fracture and one EndoButton migration.

Conclusion

Modified Weaver–Dunn reconstruction using two EndoButtons provided significant improvements in pain, function, ROM, and clinical stability with acceptable recurrence and complication rates.