Acromioclavicular Joint Repair Utilizing a Button Technique for Chronic Instability: A Case Report

Akbar Azizi Wijaya (Department of Orthopaedic, Universitas Padjadjaran, Bandung, West Java)
Romy Deviandry (Department of Orthopaedic, Universitas Padjadjaran, Bandung, West Java)
Ghuna Arioharjo Utoyo (Department of Orthopaedic, Universitas Padjadjaran, Bandung, West Java, Indonesia)

Medicinus : Jurnal Kedokteran
Vol. 14 No. 3 (2025): June

Background: Chronic acromioclavicular (AC) joint injuries are common in individuals engaged in overhead sports, resulting in persistent pain and functional limitations. This report presents a successful case of chronic AC joint injury repair using a button technique in a 26-year-old female patient, discussing the efficacy of this novel approach. Case Description: A 26-year-old female presented with a two-year history of right shoulder pain and instability following a fall during a sporting event. Despite conservative treatments, including physical therapy and corticosteroid injections, her symptoms remained unresolved, culminating in a constant pain level of 7/10 on a Visual Analog Scale (VAS) with significant impairment in daily activities. On clinical examination, tenderness over the AC joint, a prominent distal clavicle, and restricted range of motion (especially abduction) were observed. Radiographic imaging confirmed a chronic Type III AC joint injury. The patient opted for surgical intervention. Under general anesthesia, a horizontal skin incision was made over the AC joint. The joint surfaces were prepared, and the AC joint was reduced. A biodegradable button was positioned through drill holes in the acromion and the distal clavicle, securing the joint. The surgery concluded with soft tissue closure and a sterile dressing application. Postoperatively, the patient was immobilized in a sling for four weeks, followed by a structured rehabilitation program. At the 6-month follow-up, the patient reported significant pain reduction (VAS score of 2) and was able to resume all pre-injury activities, achieving a Constant-Murley score of 85—indicating a marked improvement in shoulder function. Conclusion: The button technique for repairing chronic AC joint injuries offers a minimally invasive option with promising outcomes in terms of pain relief and functional restoration. This case underscores the technique's potential as a reliable approach for similar injuries in young active individuals. Further studies are necessary to compare this method with traditional surgical techniques and to evaluate long-term outcomes.