Purpose: To measure the multiaxial stability of the acromioclavicular joint before and after transection of the acromioclavicular capsule and coracoclavicular ligaments and after sequential repair of acromioclavicular and coracoclavicular ligaments.
Methods: Biomechanical testing was performed on fresh-frozen human cadaveric shoulders (N = 6). Translational and rotational stability in the vertical and horizontal planes was measured in intact specimens, after transecting the acromioclavicular and coracoclavicular ligaments, and after sequentially performing the following procedures: single-bundle coracoclavicular repair (CCR), modified Weaver-Dunn procedure (WD), and acromioclavicular stabilization (ACS).
Results: Resecting the acromioclavicular and coracoclavicular significantly reduced translational stiffness in the inferior and anteroposterior directions, as well as rotational stiffness about the vertical and anteroposterior axes. All 3 surgical procedures increased inferior translational stiffness relative to the intact condition (Intact: 38 ± 9 N/mm, CCR: 54 ± 23 N/mm (P = .03), CCR+WD 52 ± 20 N/mm (P = .07), CCR ± WD+ACS 50 ± 21 N/mm (P = .17)). However, the combination of CCR, modified WD, and ACS resulted in the greatest increase in stiffness in internal rotation (Intact: 12.5 ± 7.4 cNm/deg, CCR: 1.2 ± 1.1 cNm/deg, CCR+WD 7.2 ± 3.0 N∗m/deg [P = .023], CCR+WD+ACS 11.6 ± 4.9 cNm/deg [P = .055]).
Conclusions: The cumulative stability of CCR, WD reconstruction, and ACS appears to be additive. Our findings provide a biomechanical justification for combining all three techniques. Biomechanical studies assessing the performance of various acromioclavicular repairs and reconstructions should therefore incorporate multiaxial testing in their protocols.
Clinical Relevance: Multiple points of fixation that provide multidirectional stability have the potential to improve clinical outcomes and reduce failure rates of acromioclavicular joint repair or stabilization.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.arthro.2021.11.051 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The acromioclavicular (AC) joint, an essential element in the complex biomechanics of the shoulder, displays a diverse range of anatomical variations among individuals. This review aimed to study and present these variations. A detailed search was conducted on the PubMed medical database by using the terms "acromioclavicular joint variations".
View Article and Find Full Text PDFImaging abnormalities of the acromioclavicular joint and subacromial space are common in asymptomatic shoulders: a systematic review.
J Orthop Surg Res
January 2025
School of Public Health and Preventive Medicine, Musculoskeletal Health and Wiser Health Care Units, Monash University, Melbourne, VIC, Australia.
Objectives: To determine the prevalence of acromioclavicular (AC) joint and subacromial space imaging abnormalities in asymptomatic adults, with a secondary objective of comparing findings between asymptomatic and symptomatic shoulders within the same study populations.
Methods: We conducted a systematic review of studies examining shoulder imaging abnormalities detected by X-ray, ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI) in asymptomatic adults (PROSPERO registration CRD42018090041). This report focuses on AC joint and subacromial space abnormalities.
Ipsilateral Rockwood type V acromioclavicular joint dislocation and midshaft clavicle fracture: A case report.
World J Orthop
December 2024
Department of Orthopedic Surgery, King Saud Medical City, Riyadh 00966, Saudi Arabia.
Article Synopsis
- Clavicle fractures are common in emergency departments, while acromioclavicular (AC) joint injuries are rare and even more so when combined with clavicle fractures.
- A 29-year-old male patient experienced both an AC joint dislocation and a midshaft clavicle fracture, leading to surgical treatment that resulted in excellent recovery and range of motion after one year.
- The case highlights the rarity of this combination of injuries and stresses the importance of timely diagnosis and investigation to achieve favorable functional outcomes, although there's still no agreement on the best treatment approach.
Triple Clavicle Injury: A Fracture of the Middle Third Associated With Acromioclavicular Dislocation and Sternoclavicular Subluxation.
Cureus
November 2024
Orthopedics and Traumatology, Hospital Francisco José Neves - Unimed Belo Horizonte (BH), Belo Horizonte, BRA.
In this report, we present a case of a triple clavicle injury, acromioclavicular joint (ACJ) dislocation, a middle third clavicle fracture, and a sternoclavicular joint (SCJ) subluxation, and describe its successful surgical treatment. A 49-year-old female patient sustained a 3 m fall, resulting in direct trauma to her left shoulder. Initial radiographs and computed tomography (CT) scans revealed a displaced middle third clavicle fracture, a high-grade ACJ dislocation, and a posterior SCJ subluxation.
View Article and Find Full Text PDFAcromioclavicular Luxation with Fracture of the Lateral End of the Clavicle: Case Report.
Rev Bras Ortop (Sao Paulo)
November 2024
Hospital Márcio Cunha, Fundação São Francisco Xavier, Ipatinga, MG, Brasil.
The present case report is an observational study with a literature review. This case is significant because the injury is rare regarding location and clinical manifestation. A middle-aged male patient sustained a fracture at the acromial end of the clavicle with lateral fragment dislocation after falling from a bicycle.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!