FUNCTIONAL AND RADIOLOGICAL OUTCOMES OF ACROMIOCLAVICULAR JOINT INJURY AND CORACOCLAVICULAR LIGAMENT RECONSTRUCTION USING SEMITENDINOSUS GRAFT IN 30 PATIENTS.

Background: Acromioclavicular (AC) joint injuries, particularly high-grade disruptions, significantly affect shoulder stability and upper limb function. Surgical reconstruction of the coracoclavicular (CC) ligaments has emerged as a reliable intervention in cases with persistent instability. This study aims to evaluate the functional and radiological outcomes of CC ligament reconstruction using autologous semitendinosus tendon graft in patients with high-grade AC joint injuries over a 2-year follow-up period. Methods: A prospective study was conducted on 30 patients (mean age: 34.2 years; range: 22–49 years) with Rockwood type III to V AC joint injuries, treated with anatomic CC ligament reconstruction using autologous semitendinosus tendon graft. Patients were evaluated clinically and radiologically at regular intervals up to 24 months postoperatively. Functional outcomes were assessed using the Constant-Murley Score (CMS), Disabilities of the Arm, Shoulder and Hand (DASH) Score, and Visual Analog Scale (VAS) for pain. Radiological assessment included the maintenance of reduction, graft integrity, and degenerative changes using standard anteroposterior and axillary views. At final follow- Results: up, the mean Constant-Murley Score improved significantly from 38.4 ± 5.6 preoperatively to 91.2 ± 4.1 (p < 0.001). The mean DASH score decreased from 52.3 ± 7.8 to 6.5 ± 3.2 (p < 0.001), and the VAS score for pain reduced from 6.7 ± 1.2 to 0.8 ± 0.5 (p < 0.001). Radiological evaluation demonstrated maintenance of anatomical reduction in 27 patients (90%), with minor loss of reduction in 3 cases (10%) without significant functional impairment. No cases of graft rupture, deep infection, or major complications were observed. Mild radiological changes of arthritis were noted in 2 patients without clinical symptoms. Anatomical coracoclavicular ligament Conclusion: reconstruction using autologous semitendinosus graft provides excellent functional and radiological outcomes in high-grade AC joint injuries. The procedure is safe, biomechanically stable, and effective in restoring shoulder function over a 2-year follow-up. Early surgical intervention and meticulous technique are key factors for optimal outcomes.