The Use of Semitendinosus Tendon Graft versus Modified Weaver-Dunn Procedure for Treatment of Acromioclavicular Joint Dislocation: A Comparative Study

Document Type : Original Article


The Department of Orthopedic Surgery, Faculty of Medicine, Al-Azhar*, Zagazeg** and Cairo*** Universities


Abstract Background: Biomechanical studies comparing various surgical techniques for acromioclavicular joint reconstruction have reported that semitendinosus tendon graft for coracocla-vicular ligament reconstruction provides a substantial im-provement in initial stability and a load-to-failure equivalent to the intact coracoclavicular ligaments. Although it represents a biomechanical improvement compared with coracoacromial ligament transfer, there is still a lack of prospective comparative studies confirming the clinical relevance of these biomechanical findings. Aim of Study: The aim of this study is to compare and evaluate the clinical and radiological results of using Semi-tendinosus Tendon Graft versus Modified Weaver-Dunn Pro-cedure for treatment of Acromioclavicular Joint Dislocation. Patients and Methods: Prospective Comparative Ran-domised Control Study included 40 patients with 40 shoulders diagnosed clinically and radiologically as Rockwood type III and type V Acromioclavicular joint dislocations underwent operative treatment of AC dislocation; 20 patient (group A) treated by modified Weaver-Dunn operation with mean follow-up 14.4 months and the other 20 patient (group B) treated by reconstruction with Semitendinosus autograf T with mean follow-up 12 months. Clinical evaluation was performed using the Constant score. Preoperative and postoperative radiographs were compared. Results: The mean Constant score improved from 55 points to 86 points in the Weaver-Dunn group, and from 60 points to 89 points in the semitendinosus tendon group (p<.37). The radiologic measurements showed a mean coracoclavicular distance in the Weaver-Dunn group become 11.20mm, com-pared with 10.6mm in the semitendinosus tendon group (p<.92). Both groups achieved significant improvements in both range of motion and functional activity according to Constant score. In our study, we saw a trend to wards better results in semitendinosus tendon group than Weaver-Dunn group although not on a significant level.
Conclusion: Semitendinosus tendon graft for coracocla-vicular ligament reconstruction resulted in superior clinical and radiologic outcomes compared to the modified Weaver-Dunn procedure but not on a significant level.