Dermal Allograft Reconstruction of the Superior Acromioclavicular Capsuloligamentous Complex With Knotless Suture Anchors

Acromioclavicular (AC) joint instability can significantly impact the shoulder girdle, causing notable pain and impaired function. Surgical management traditionally focuses on reconstruction of the coracoclavicular ligaments, providing reduction and stability in the coronal plane. Failure to address sagittal plane stability, including the AC capsuloligamentous complex and the superior joint capsule, can result in suboptimal outcomes in the setting of distal clavicle excision or coracoclavicular ligament reconstruction. We describe a surgical technique for superior AC capsule reconstruction utilizing dermal allograft with knotless suture anchors, shown in this case to address inadequate repair after prior open distal clavicle excision. This low-profile technique has the advantage of clavicular bone preservation with minimal anchor burden and a single drill corridor, lending to its application as an adjunct to traditional coracoclavicular reconstruction techniques.