Study finds, Radiographic alterations in Clavicular bone tun
A Study was conducted to evaluate tunnel widening and its relationship in loss of reduction and clinical outcomes in patients undergoing anatomic coracoclavicular ligament reconstruction (ACCR) using free tendon grafts for chronic acromioclavicular (AC) joint injuries.

A retrospective chart review was performed on patients undergoing ACCR for type III–VI AC joint injuries. For radiographic analysis, pre- and post-operative coracoclavicular distance (CCD) and tunnel width of the medial and lateral clavicular bone tunnel were measured at the earliest (EPO) and latest postoperative follow-up (LPO). To determine the clinical relevance of improvement in clinical outcome score substantial clinical benefit (SCB), and patient acceptable symptomatic state (PASS) thresholds were used.

Results:
--24 patients with a mean clinical follow-up of 37 ± 35 months (mean age 44.7±13.4) were included in the study.

--Both the medial and lateral clavicular bone tunnel showed significant widening from EPO to LPO. There was a significant loss of reduction at LPO compared to EPO.

--No significant correlation between loss of reduction and medial or lateral tunnel widening was found. Alterations in tunnel width were shown having no influence on clinical outcomes.

In the end, there was substantial extension of the clavicular bone tunnel during the postoperative stage of ACCR patients who had received ACCR with a free tendon graft for treatment of chronic type III–VI ACJ injuries. The radiographic findings had no affect on clinical benefit and satisfaction. No link between tunnel explosion and loss of reduction was identified.

Source: https://link.springer.com/article/10.1007/s00167-020-05980-z
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