Acromioclavicular (AC) Joint Reconstruction

Anesthesia

• General anesthesia or sedation with interscalene block

• No paralysis

• No foley catheter

• 2 gm Cefazolin (if PCN allergy, 1 gm Vancomycin)

• Irrigation fluid with Epinephrine (0.33 mg/L)

 

Positioning

• Beach chair position, Spyder arm holder, padded leg cushion

• OR bed turned 90° from anesthesia (i.e. perpendicular to anesthesia)

• Foot-control electrocautery (Ambient MegaTurbo Vac) and shaver (4.5 mm S&N Incisior Elite Premium straight)

• Two sterile U-drapes with Steri-Drape U-Pouch

 

Surgery

• Equipment

  • Arthroscopy tower (most of procedure is arthroscopic)

  • Large C-arm (not Neuro)

  • Shoulder arthroscopy instruments with 30° and 70° scopes

  • Power drill

  • Two baby Hohmans

• Cannulas

  • None

• Implants

  • Arthrex DogBone button (product #2270) x 2

  • Arthrex Tightrope (product #1588TN)

  • Arthrex SutureTape 30mm

  • Arthrex FiberStick x 1

  • Arthrex 3.0 mm cannulated drill bit

  • Arthrex DogBone targeting drill guide

 

Closure

• 2-0 Vicryl x 1

• 1/2" steri-strips cut in half

• 4x4 gauze with foam tape about the shoulder

• Shoulder brace/sling will be brought by surgeon

• Discharge home​

 

Resources