Anatomical versus non-anatomical configuration of double coraco-clavicular tunnel technique in acromioclavicular joint reconstruction

Abstract

Purpose Horizontal instability is a common problem after acromioclavicular joint injuries. The aim of this study was to evaluate if there is a difference regarding horizontal stability between an anatomical and a non-anatomical configuration of the double tunnel coraco-clavicular ligament reconstruction of the acromioclavicular joint. Methods Thirteen acromioclavicular joints of human cadaveric shoulders in ethanol-glycerin fixation were included in the study and underwent cyclic anterior and posterior translational testing at a load of 70 N using an electromechanical uniaxial testing machine. The shoulders were randomly assigned to the following groups: double coraco-clavicular tunnel technique in an anatomical configuration (DCTa) and double coraco-clavicular tunnel technique in an inverse configuration of the anatomical position (DCTb). The dislocation was recorded with a 3D optical measuring system. Results The total horizontal displacement (p10 = 0.0221; p5000 = 0.082) was significantly higher for the non-anatomical reconstruction (DCTb) compared to the anatomical reconstruction (DCTa) after every measured amount of cycles. The increase in displacement for DCTb group was overall higher than the increase in displacement for DCTa group but without significance. Conclusion Reconstruction of the CC ligaments in an anatomical configuration with two suture devices results in a significantly higher stability of the AC joint in the horizontal plane than reconstruction of the CC ligaments in a non-anatomical configuration. Based on the results of this biomechanical in vitro study, the use of a double coraco-clavicular reconstruction should focus on an anatomically correct position of the suture devices.

Bibliometric and visualized analysis of arthroscopic treatment of acromioclavicular joint injury

“…The largest cluster consists of nine authors, but their research is focused on between 2016 and 2018. The Schoebel T[ 21 ]-centered cluster (7 authors), whose research in this field is concentrated after 2020, is a relatively new and closely cooperative research team, and it is also a team with great potential in the current field. The top three authors of total link strength are Scheibel [ 17 ](TLS = 15), Boyer [ 22 ](TLS = 15), and Barth [ 23 ] (TLS = 14), which shows that the three authors have done more cooperation with others.…”

Morphology of the acromioclavicular-joint score (MAC)

“…Usually failed conservative therapy over a time period of months is the indication for AC-joint resection or resection of the lateral clavicle [ 14 ]. This procedure can be performed either in an open fashion or arthroscopically [ 21 , 28 , 31 ]. Because of the preservation of the superior capsule, the preference and better outcome are attributed to the arthroscopic technique nowadays [ 4 , 7 , 15 , 23 , 26 ].…”

Acromioclavicular Joint Reconstruction with Recessed Clavicular Implant Technique Guide

“…Studies have demonstrated that fixation with suture or suture tape for AC ligament repair have demonstrated similar biomechanical strength to the native AC and coracoclavicular (CC) ligaments. 8 Arthroscopic techniques are less invasive compared to open procedures. 4,9 Pan and colleagues 10 conducted a metaanalysis comparing the arthroscopic tape reconstruction to the hook and plate technique for Rockwood types III-V AC dislocations and found similar outcomes between the techniques for postoperative reduction (coracoclavicular distance weighted mean difference [WMD] 0.24, 95% confidence interval [CI] À0.67, 1.15; P ¼ .602 and function of the AC joint (constant score WMD 6.12; 95% CI À3.84, 16.08; P ¼ .229); however, tape fixation resulted in less postoperative pain and improved cosmesis compared to the hook and plate technique (VAS WMD À0.69; 95% CI À1.10, À0.27; P ¼ .001).…”