It is possible to reconstruct the coracoclavicular ligaments with synthetic suture material (fibrewire).
It is possible to insert this in an all arthroscopic way or open. A hole is drilled in the clavicle and coracoid base and the fibrewire passed through the holes. The fibrewire is secured under the coracoid and above the clavicle with a button.
Although it is possible to do this all arthroscopically and with small incisions, it is a technically demanding procedure.
It requires drilling a hole in the base of the coracoid. This weakens the coracoid and if multiple passes are used with the guide wire or the coracoid is drilled eccentrically it can significantly weaken the coracoid.
The single strand construct may also fatigue fail, hence the double strand construct was devised. This also replicates normal anatomy, the CC ligament composed of two distinct strands. Although this is mechanically much stronger the risk of coracoid fracture remains. A coracoid fracture although rare is difficult to deal with. The larger the hole in the base of the coracoid the greater the risk of fracture.