A modified weaver-dunn procedure with or without chip bone graft for the treatment of acromioclavicular joint separation

Abstract

Background: In spite of frequent injuries to the acromioclavicular (AC) joint, there is no consensus regarding optimal technique to be used. This cohort study evaluated the clinical results of a modified Weaver-Dunn procedure with or without chip bone graft for the treatment of AC joint separation retrospectively. Materials and Methods: 60 consecutive patients with AC joint separation, between the age of 19-76 years (mean age 43 years), were enrolled between January 2005 and September 2011. Forty patients (35 men, 5 women) were treated with a modified Weaver-Dunn procedure, and did not receive bone graft during the procedure (Group 1), whereas twenty patients (19 men, 1 woman) received autogenous chip bone graft (Group 2). Stability of the AC joint was evaluated clinically and radiographically, and the clinical results were assessed by the Imatani evaluation system. Results: The mean duration of followup was 2 years and 2 months. The results were excellent in all patients except one. At final followup, roentgenographic measurement revealed that the mean coracoclavicular interval was 8.2 mm on the affected side, and 8.9 mm on the unaffected side in Group 1, and 9.5 mm on the affected side and 10.1 mm on the unaffected side in Group 2. For Group 1, there were significant differences between augmentation of the grafted coracoacromial (CA) ligament antero-posteriorly and laterally (Option B) and repair of the torn AC ligament with augmentation of the grafted CA ligament antero-inferiorly (option A; P = 0.0351). Conclusions: The modified Weaver-Dunn procedure (Group 1 and 2) provides a stable and strong reconstruction for the treatment of AC joint separation. In addition, this modified Weaver-Dunn procedure with chip bone graft (Group 2) may lead to same or more secure healing of the grafted CA ligament-bone than the same procedure without chip bone graft (P = 0.9737).