Abstract:[Objective] To evaluated the clinical outcomes of double- bundle reconstruction of coracoclavicular ligament with Rigid- loop for type III acromioclavicular dislocation. [Methods] A retrospective study was conducted on 48 patients who received surgical treat- ment for Rockwood III acromioclavicular dislocation in our hospital from June 2019 to June 2020. According to preoperative doctor-patient communication, 22 patients received hook plate fixation, while the remaining 26 patients underwent double-bundle reconstruction of cora- coclavicular ligament with Rigidloop. Perioperative period, follow-up and imaging data were compared between the two groups. [Results] All patients in both groups had corresponding surgical procedures performed successfully, without a significant difference in the operation time between the two groups (P＞0.05). The reconstructed group proved significantly superior to the hook plate group in terms of the total length of incision [(4.3±0.5) cm vs (7.0±0.8) cm, P＜0.05], intraoperative blood loss [(62.0±15.8) ml vs (97.1±26.5) ml, P＜0.05] and hospital stay [(11.1±2.3) days vs (14.3±2.9) days, P＜0.05]. The VAS scores significantly decreased in both groups (P＜0.05), the CRP was significant- ly increased (P＜0.05), whereas the IL-6 remained unchanged in both group over time in the early stage postoperatively (P＞0.05), which in the reconstructed group were significantly better than the hook plate group at all time point accordingly during the early stage (P＜0.05). All patients were followed up for (22.2±2.5) months on an average, with no a significant difference in the time to return to full weight-bearing activities between the two groups (P＞0.05). The UCLA score, shoulder abduction-lifting, forward flexion-lifting, internal rotation and exter- nal rotation range of motions (ROMs) were significantly increased in both groups over time (P＜0.05). At the latest follow-up the reconstruct- ed group was significantly superior to the hook plate group regarding UCLA score [(32.5±3.7) vs (29.1±3.1), P=0.002], abduction-lifting ROM [(151.4±10.4)° vs (135.6±12.4)°, P＜0.001], internal rotation ROM [(62.9±13.0)° vs (52.1±11.4)°, P=0.004] and external rotation ROM [(66.6±9.4)° vs (57.0±9.4)°, P=0.001]. Radiographically, the coracoclavicular distance (CC) and the acromioclavicular distance (AC) de- creased significantly 3 months after surgery compared with those preoperatively results (P＜0.05), whereas which proved not statistically sig- nificant between the two groups at any corresponding time points (P＞0.05). [Conclusion] The double-bundle reconstruction of coracoclavic- ular ligament with Rigidloop for type III acromioclavicular dislocation has the advantages of less trauma, faster postoperative recovery, less postoperative pain, lower postoperative inflammation reaction, and better joint function over the hook plate fixation.