In:
The American Journal of Sports Medicine, SAGE Publications, Vol. 34, No. 2 ( 2006-02), p. 236-246
Abstract:
Despite numerous surgical techniques described, there have been few studies evaluating the biomechanical performance of acromioclavicular joint reconstructions. Purpose To compare a newly developed anatomical coracoclavicular ligament reconstruction with a modified Weaver-Dunn procedure and a recently described arthroscopic method using ultrastrong nonabsorbable suture material. Study Design Controlled laboratory study. Methods Forty-two fresh-frozen cadaveric shoulders (72.8 ± 13.4 years) were randomly assigned to 3 groups: arthroscopic reconstruction, anatomical coracoclavicular reconstruction, and a modified Weaver-Dunn procedure. Bone mineral density was obtained on all specimens. Specimens were tested to 70 N in 3 directions, anterior, posterior, and superior, comparing the intact to the reconstructed states. Superior cyclic loading at 70 N for 3000 cycles was then performed at a rate of 1 Hz, followed by a load to failure test (120 mm/min) to simulate physiologic states at the acromioclavicular joint. Results In comparison to the intact state, the modified Weaver-Dunn procedure had significantly (P 〈 . 05) greater laxity than the anatomical coracoclavicular reconstruction or the arthroscopic reconstruction. There were no significant differences in bone mineral density (g/cm2), load to failure, superior migration over 3000 cycles, or superior displacement. The anatomical coracoclavicular reconstruction had significantly less (P 〈 . 05) anterior and posterior translation than the modified Weaver-Dunn procedure. The arthroscopic reconstruction yielded significantly less anterior displacement (P 〈 . 05) than the modified Weaver-Dunn procedure. Conclusion The anatomical coracoclavicular reconstruction has less anterior and posterior translation and more closely approximates the intact state, restoring function of the acromioclavicular and coracoclavicular ligaments. Clinical Relevance A more anatomical reconstruction using a free tendon graft of both the trapezoid and conoid ligaments may provide a stronger, permanent biologic solution for dislocation of the acromioclavicular joint. This reconstruction may minimize recurrent subluxation and residual pain and permit earlier rehabilitation.
Type of Medium:
Online Resource
ISSN:
0363-5465
,
1552-3365
DOI:
10.1177/0363546505281795
Language:
English
Publisher:
SAGE Publications
Publication Date:
2006
detail.hit.zdb_id:
197482-8
detail.hit.zdb_id:
2063945-4
SSG:
31
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