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Biomechanical analysis of acromioclavicular joint dislocation repair using coracoclavicular suspension devices in two different configurations.

Abat F, Sarasquete J, Natera LG, Calvo Á, Pérez-España M, Zurita N, Ferrer J, del Real JC, Paz-Jimenez E, Forriol F - J Orthop Traumatol (2015)

Bottom Line: The best treatment option for some acromioclavicular (AC) joint dislocations is controversial.The corresponding force was 939.37 N (mean 495.6 N) for group II and 533.11 N (mean 343.9 N) for group III.A comparison of the three groups did not find any significant difference despite the loss of resistance presented by group III.

View Article: PubMed Central - PubMed

Affiliation: Department of Sports Orthopaedics, ReSport Clinic, Barcelona, Spain, ferranabat@gmail.com.

ABSTRACT

Background: The best treatment option for some acromioclavicular (AC) joint dislocations is controversial. For this reason, the aim of this study was to evaluate the vertical biomechanical behavior of two techniques for the anatomic repair of coracoclavicular (CC) ligaments after an AC injury.

Materials and methods: Eighteen human cadaveric shoulders in which repair using a coracoclavicular suspension device was initiated after injury to the acromioclavicular joint were included in the study. Three groups were formed; group I (n = 6): control; group II (n = 6): repair with a double tunnel in the clavicle and in the coracoid (with two CC suspension devices); group III (n = 6): repair in a "V" configuration with two tunnels in the clavicle and one in the coracoid (with one CC suspension device). The biomechanical study was performed with a universal testing machine (Electro Puls 3000, Instron, Boulder, MA, USA), with the clamping jaws set in a vertical position. The force required for acromioclavicular reconstruction system failure was analyzed for each cadaveric piece.

Results: Group I reached a maximum force to failure of 635.59 N (mean 444.0 N). The corresponding force was 939.37 N (mean 495.6 N) for group II and 533.11 N (mean 343.9 N) for group III. A comparison of the three groups did not find any significant difference despite the loss of resistance presented by group III.

Conclusion: Anatomic repair of coracoclavicular ligaments with a double system (double tunnel in the clavicle and in the coracoid) permits vertical translation that is more like that of the acromioclavicular joint. Acromioclavicular repair in a "V" configuration does not seem to be biomechanically sufficient.

No MeSH data available.


Related in: MedlinePlus

Scheme for anatomic repair of the coracoclavicular ligaments in a “V” configuration. Note the arrangement of a single CC suspension device with two tunnels in the clavicle and one in the coracoid
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Fig2: Scheme for anatomic repair of the coracoclavicular ligaments in a “V” configuration. Note the arrangement of a single CC suspension device with two tunnels in the clavicle and one in the coracoid

Mentions: In the reconstruction with a single tunnel in the coracoid (group III) for isometric repair of the CC ligaments in a “V” configuration (Fig. 2), two tunnels were created in the clavicle at the usual insertion of the conoid and trapezoid ligaments and one was made at the base of the coracoid (at the midpoint of the insertion of both ligaments). The CC suspension device was put in place with the titanium component locked into the base of the coracoid, passing through the tunnel inversely. Each loop of the device was then passed through the corresponding tunnel in the clavicle so as to obtain a repair of the CC ligaments with a single implant in a “V” configuration.Fig. 2


Biomechanical analysis of acromioclavicular joint dislocation repair using coracoclavicular suspension devices in two different configurations.

Abat F, Sarasquete J, Natera LG, Calvo Á, Pérez-España M, Zurita N, Ferrer J, del Real JC, Paz-Jimenez E, Forriol F - J Orthop Traumatol (2015)

Scheme for anatomic repair of the coracoclavicular ligaments in a “V” configuration. Note the arrangement of a single CC suspension device with two tunnels in the clavicle and one in the coracoid
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4559546&req=5

Fig2: Scheme for anatomic repair of the coracoclavicular ligaments in a “V” configuration. Note the arrangement of a single CC suspension device with two tunnels in the clavicle and one in the coracoid
Mentions: In the reconstruction with a single tunnel in the coracoid (group III) for isometric repair of the CC ligaments in a “V” configuration (Fig. 2), two tunnels were created in the clavicle at the usual insertion of the conoid and trapezoid ligaments and one was made at the base of the coracoid (at the midpoint of the insertion of both ligaments). The CC suspension device was put in place with the titanium component locked into the base of the coracoid, passing through the tunnel inversely. Each loop of the device was then passed through the corresponding tunnel in the clavicle so as to obtain a repair of the CC ligaments with a single implant in a “V” configuration.Fig. 2

Bottom Line: The best treatment option for some acromioclavicular (AC) joint dislocations is controversial.The corresponding force was 939.37 N (mean 495.6 N) for group II and 533.11 N (mean 343.9 N) for group III.A comparison of the three groups did not find any significant difference despite the loss of resistance presented by group III.

View Article: PubMed Central - PubMed

Affiliation: Department of Sports Orthopaedics, ReSport Clinic, Barcelona, Spain, ferranabat@gmail.com.

ABSTRACT

Background: The best treatment option for some acromioclavicular (AC) joint dislocations is controversial. For this reason, the aim of this study was to evaluate the vertical biomechanical behavior of two techniques for the anatomic repair of coracoclavicular (CC) ligaments after an AC injury.

Materials and methods: Eighteen human cadaveric shoulders in which repair using a coracoclavicular suspension device was initiated after injury to the acromioclavicular joint were included in the study. Three groups were formed; group I (n = 6): control; group II (n = 6): repair with a double tunnel in the clavicle and in the coracoid (with two CC suspension devices); group III (n = 6): repair in a "V" configuration with two tunnels in the clavicle and one in the coracoid (with one CC suspension device). The biomechanical study was performed with a universal testing machine (Electro Puls 3000, Instron, Boulder, MA, USA), with the clamping jaws set in a vertical position. The force required for acromioclavicular reconstruction system failure was analyzed for each cadaveric piece.

Results: Group I reached a maximum force to failure of 635.59 N (mean 444.0 N). The corresponding force was 939.37 N (mean 495.6 N) for group II and 533.11 N (mean 343.9 N) for group III. A comparison of the three groups did not find any significant difference despite the loss of resistance presented by group III.

Conclusion: Anatomic repair of coracoclavicular ligaments with a double system (double tunnel in the clavicle and in the coracoid) permits vertical translation that is more like that of the acromioclavicular joint. Acromioclavicular repair in a "V" configuration does not seem to be biomechanically sufficient.

No MeSH data available.


Related in: MedlinePlus