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Background: Operative procedure in chronic cases of Acromioclavicular joint dislocation remains controversial. The modified weaver-dunn method is one of the most popular methods but it is a non anatomic technique that presents approx 30:/: loss of reduction and horizontal instability. Anatomic Coracoclavicular ligament reconstruction using autogenous tendon graft reportedly diminishes pain, eliminates sequelae, and improves function as well as strengthstrength, still it also having some complications like clavicle fracture, coracoid fracture or hyperaesthsia due to infrapatellar branch of sapheneous nerve ( while taking hamstring tendon graft) Objective: To compare functional outcomes between modified weaver –Dunn procedure and anatomic coracoclavicular ligament reconstruction technique using semitendinosus tendon graft. Method Fifty six patients (mean age, 31 years) with painful, chronic Rockwood type 3, 4, and 5 acromioclavicular joint dislocation were subjected to surgical intervention. All patients randomly divided in 2 groups, group A for anatomic coracoclavicular reconstruction using semitendinosus tendon (ST) graft and group B for modified weaver-dunn procedure. Clinical evaluation was performed using American shoulder and elbow surgeons shoulder score (ASES) and the constant score after follow up of 6 months Results In the ST group (group A), the mean ASES shoulder score improved from 76.92+/-5.73 preoperatively to 95.14+/-3.85 postoperatively and mean constant score from 69.96 +/-6.70 preoperatively to 94.21+/-2.79 postoperatively. In the weaver-dunn group (group B), the mean ASES shoulder score improved from 76.78+/-5.76 preoperatively to 88.82+/-2.29 postoperatively and mean constant score improved from 69.50+/-5.87 preoperatively to 85.50+/-3.34 postoperatively. The results in the semitendinosus tendon graft grouwere significantly better than in the weaver–dunn group (p<0.05). Conclusion Semitendinosus tendon graft for coracoclavicular ligament reconstruction resulted in significantly superior functional outcomes compared to the modified Weaver-Dunn procedure.
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