Biomechanical Comparison of Reconstruction Techniques for Disruption of the Acromioclavicular and Coracoclavicular Ligaments

Albert W. Pearsall IV, MD, J. Marcus Hollis, PhD, George V. Russell, Jr., MD, David A. Stokes, MD

Disclosures

J South Orthop Assoc. 2002;11(1) 

In This Article

Results

The clavicular hole diameter was 4 mm, with the hole distance averaging 10 mm from the anterior clavicular cortex. The average coracoacromial ligament width was 15.7 mm and the average ligament graft width was 8.1 mm.

Preliminary testing at forces greater than 50 N showed clavicular fracture before failure of the surgical construct. Therefore, displacement was recorded and stiffness was calculated, but failure load and mechanism of failure were not recorded. No bone damage was noted with the maximum testing load used. All coracoclavicular displacement recorded occurred due to collagenous fiber micro failure and/or suture failure. The intact shoulder showed significantly less coracoclavicular displacement than any of the reconstructions (P = .0001) (Fig 2). Merselene tape (No. 5) plus CAC ligament showed the largest coracoclavicular displacement. The PDS braid with CAC ligament showed the least displacement. The PDS braid alone showed less displacement than Merselene with CAC ligament, but this was not significant (P = .71). The difference in displacement between No. 5 Merselene plus ligament and No. 1 PDS plus ligament was not significant (P = .16), though there was a trend toward decreased displacement with the use of the PDS braid plus CAC ligament. The intact ligament showed significantly more stiffness than any of the reconstructions (Fig 3). Among the 3 reconstructions, the PDS braid plus ligament showed greater stiffness than either the PDS braid alone or the Merselene plus ligament, though this difference was not statistically significant.

Measurement of coracoclavicular displacement between intact shoulder and three reconstruction procedures.

Calculations of stiffness for intact shoulder and three reconstruction procedures.

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