An acute Grade 3 AC separation generally is defined as a superiorly displaced clavicle that follows an injury within 2 months. Historically, these injuries have done poorly with bracing ("Kenny Howard brace") and with surgical intervention.
Late reconstructions have been limited to those with pain--either Weaver-Dunn arthroplasties or Mumford procedures.
A new implant from Arthrex has altered the landscape, however,making it feasible to perform a minimally invasive arthroscopic reduction of the AC joint. This technique reduces the AC joint and allows the coracoclavicular ligaments to heal. The implant is called the "tight rope." Early clinical outcome reports appear very satisfactory. Indeed, restoration of anatomy, with little morbidity begs the question--"Why not?"
