Radiographic features and complications following coracoclavicular ligament reconstruction

  • Brian P. KennedyEmail author
  • Zehava Sadka Rosenberg
  • Michael J. Alaia
  • Mohammad Samim
  • Erin F. Alaia
Scientific Article



To report radiographic features and complications of coracoclavicular ligament reconstruction and the association of radiographic features with symptomatology.

Materials and methods

Retrospective picture archiving and communication system query (1/2012–8/2018) identified subjects with prior coracoclavicular ligament reconstruction. Post-operative radiographs were reviewed with attention to the following: (1) acromioclavicular alignment, (2) coracoclavicular width, (3) distal clavicular osteolysis, (4) osseous tunnel widening, and (5) hardware complication or fracture. Medical records were reviewed to determine purpose of imaging follow-up (symptomatic versus routine). Statistical analysis determined associations between binary features and outcomes, and inter-reader agreement.


Review of 55 charts identified 32 subjects (23 male, 9 females; age range 24–64; imaged 1–34 months following surgery) meeting inclusion criteria. Loss of acromioclavicular reduction was the most common imaging finding (n = 25, 78%), with 76% progressing to coracoclavicular interval widening. Distal clavicular osteolysis was seen in 21 cases (66%) and was significantly associated with loss of acromioclavicular joint reduction (p = 0.032). Tunnel widening occurred in 23 patients (82%) with more than one follow-up radiograph. Six (19%) had hardware complication or fracture. No radiographic feature or complication had significant correlation with symptomatology (p values 0.071–0.721). Inter-reader agreement was moderate to substantial for coracoclavicular interval widening and hardware complication, fair to substantial for tunnel widening, and fair to moderate for loss of acromioclavicular reduction and distal clavicular osteolysis.


Loss of acromioclavicular joint reduction, coracoclavicular interval widening, distal clavicular osteolysis, and tunnel widening are common radiographic features after coracoclavicular ligament reconstruction; however, they do not necessarily correlate with symptomatology.


Shoulder Coracoclavicular reconstruction Post-operative 



We would like to thank Dr. James Babb for providing statistical analysis for our study.

Supplementary material

256_2020_3375_MOESM1_ESM.docx (182 kb)
ESM 1 (DOCX 181 kb)


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Copyright information

© ISS 2020

Authors and Affiliations

  • Brian P. Kennedy
    • 1
    • 2
    Email author
  • Zehava Sadka Rosenberg
    • 1
  • Michael J. Alaia
    • 3
  • Mohammad Samim
    • 1
  • Erin F. Alaia
    • 1
  1. 1.Department of Radiology, Musculoskeletal Division, NYU Langone Orthopedic HospitalNYU Langone HealthNew YorkUSA
  2. 2.University Radiology GroupEast BrunswickUSA
  3. 3.Department of Orthopaedic Surgery, Sports Surgery Division, NYU Langone Orthopedic HospitalNYU Langone HealthNew YorkUSA

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