Capsular Reconstruction of the Acromioclavicular Joint With a Fascia Lata Autograft: The Wrap Technique

Numerous techniques have been described for the treatment of acute and chronic acromioclavicular joint dislocations, usually addressing only the coracoclavicular ligaments without including acromioclavicular joint reconstruction. However, failure of acromioclavicular reconstruction procedures may occur due to persistent horizontal instability. A surgical technique is described, where, in addition to coracoclavicular ligament reconstruction with a semitendinosus autograft, acromioclavicular joint capsule reconstruction is performed via a fascia lata autograft. The fascia lata autograft is attached to the distal clavicle and the acromion, enveloping the anterior, superior, and posterior surfaces of the acromioclavicular joint. The autograft is stabilized with either bone anchors or transosseous sutures. The described technique improves horizontal plane stability, is simple to perform, and can be applied in both acute and chronic acromioclavicular joint instability.