AC Separation repaired by Dr Mark

Hey everyone, I just wanted to give a public thank you to Dr Mark and his staff at the Sanders Clinic in Houston, Texas. I went out last week and had him fix my grade 5 AC Separation. Everything went as smooth as could be, from the flight out through the flight back, to include the surgery and office visits.

My left arm now feels as strong as my right arm does and as strong as it used to be before the crash. It feels stable, which is something that I really hadn't realized that I had lost until I got it back. I have full range of motion, albeit, it's still sore since the surgery was only a few days ago, but I'm not in a sling and unless you knew I had shoulder surgery, you couldn't tell.

The worst part for me was that Dr Mark and staff are such great people that it's like leaving your friends behind when it's time to go.

Thank you again Dr Mark for everything.


Dave Yeski



That looks to be a bit different than Dr Mark’s signature repair “Two heavy sutures are placed under the coracoid process and brought through 2 mm drill holes in the clavicle” because of the grade 5. Is that considered a hook plate?

Yes, it is. He gave me a choice and based on my level of activity and the percentage of successes comparatively for each type of procedure, I chose the hook plate for my repair. My grade 5 was pretty far out so we thought this was the best way to go for me.


I have changed my signature repair for this problem. This is a far more favorable situation. The only problem is that insurer only a small fixed amount to the hospitals for repair of AC injury. The plate and screws costs about $1400. Some people with private insurance will not  be able to afford to have it.  You all know who to thank for that one.

Edited by DrMark

Is this due to a better result or because of lower cost? Asking as I'm coming up on two years with my grade 5, and although I can manage any pain, there is a definite a loss in strength that i would like to correct with my active sports life, but as of now haven't been able to find anyone here in Canada that would do the suture technique for my chronic condition. However, I could get the hook plate, but have deferred as I understood this required a second surgery to remove the plate and that more holes are required for the screws into the clavicle (similar to the concern with the graft?).

The problem that I am encountering now is the cost of the hook plate, rather than the cost of the removal. The small screw holes aren't the problem.   Unless someone in the USA, has platinum class insurance, the hospitals won't let me use it.  The insurance world could care less if I operate on a guy 100 times.  Its whether or not I have to use an expensive instrument or implant that they won't tolerate.  This Obamacare stuff is becoming a real pain in the butt. 


I have been working on a new way to make the oval holes in the clavicle to pass a tendon graft is a manner that is much less likely to result in a clavicle fracture.  The good thing about this is that there is no obligatory hardware removal.  The bad thing is that I can't start the patient on early motion, and a small amount of slippage is more likely.  Either way the hook plate is off the menu in Texas.

Edited by DrMark

Thanks for the explanation Dr. Mark....crazy bureaucracy. What has caused you to change your signature repair? Is the graft (with smaller holes) or hook plate a better option than the suture technique for chronic grade 5 conditions?

My signature repair has changed because no one can afford my short lived previous signature repair.  From now on I will do an anatomic ligament reconstruction with a graft taken from the iliotibial band of the thigh.  The hook plate is a good option for a patient from Saudi Arabia, Bahrain, and Abu Dubai.  Otherwise it just isn't on the menu anymore for American patients who look to pay with their insurance card.

Why is the suture technique more expensive? Is it because it is more involved procedure?

IYO, it is a better fix, no? Curious, as I had written off the graft due to your previous responses (which I agreed with...).

The hook plate is 1700 dollars for the hospital to buy.  That is just about what the insurance company pays the hospital.  There is no money left even for an aspirin or a box of Kleenex. So it is off the menu for now.   I have refined my own method of doing the ligament reconstruction in a safe way and will do those in the cases in which the hook plate is not available.  The ligament reconstruction is backed by my old school suture repair.

What Dr.Mark is trying to say.... OBMACARE is killing good procedures because of cost!




Feel free to correct me Dr.Mark ;)

Edited by Badbeat

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