Despite the differences compared to the normal coracoclavicular ligament complex, the anatomical reconstruction complex more closely approximates the stiffness of the coracoclavicular ligament complex than current surgical constructs, and the incorporation of biological tissue could improve the overall structural properties with healing.
The goal of this study was to develop a new device for the measurement of rotational knee laxity and to measure intra-observer and inter-observer reliability in a cadaveric study. An array of established tools was utilized to design the device with a basis that consists of an Aircast Foam Walkertrade mark boot. A load cell was attached to the boot with a handle bar for application of moments about the knee. An electromagnetic tracking system was used to record the motion of the tibia with respect to the femur. The total arc of motion ranged from 23 degrees at full extension to 46 degrees at 90 degrees of knee flexion. The intra-tester ICCs ranged from 0.94 to 0.99. The ICC for inter-tester reliability ranged from 0.95 to 0.99. In summary, the new device for measurement of rotational knee laxity is simple, reliable, and can be used in a non-invasive fashion in the office or surgical suite document clinical outcome in terms of rotational knee laxity.
During contact sports such as football, hockey or rugby, the coracoclavicular ligaments are commonly ruptured. Currently, the limited biomechanical data on the properties and function of these ligaments have led to debate on the "gold standard" treatment for these injuries. Therefore, the objective of this study was to characterize the geometry, viscoelastic behavior and structural properties of the coracoclavicular ligaments (n=11). The trapezoid and conoid were found to have similar length (9.6+/-4.4 vs. 11.2+/-4.1 mm) and cross-sectional area (103+/-43 vs. 69+/-51 mm2), respectively (P>0.05). Static and cyclic stress relaxation tests were then performed, followed by uniaxial tensile testing with the insertions of each ligament aligned to ensure a uniform distribution of load across the fibers. No significant differences were observed for the trapezoid and conoid during the static (36+/-8% vs. 31+/-7%) and cyclic (23+/-12% vs. 16+/-6%) stress relaxation tests, respectively (P>0.05). Similarly, no statistically significant differences were found between the trapezoid and conoid for linear stiffness (83+/-40 vs. 70+/-23 N mm(-1)), ultimate load (312+/-133 vs. 266+/- 108 N), energy absorbed at failure (820+/-576 vs. 752+/- 410 N mm), percent elongation (74+/-47% vs. 62+/-22%) and elongation at failure (5.8+/-2.2 vs. 6.1+/-1.6 mm), respectively (P>0.05). A comparison of our data to previous studies suggests that the complex fiber orientation of these ligaments has a significant role in determining the maximum load that can be transferred between the clavicle and scapula by each bone-ligament-bone complex. Our findings also further confirm the functional role of the coracoclavicular ligaments in supporting the upper extremity, and provide data for reconstruction and rehabilitation protocols as well as computational models.
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