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. 2023 Apr;15(2):166-172.
doi: 10.1177/17585732211068322. Epub 2022 Jan 24.

Anatomic Acromioclavicular Joint Reconstruction with and without Acromioclavicular Ligament Reconstruction: A Comparative Biomechanical Study

Steven M Johnson  1   2   3 , Amanda O Esquivel  1   4 , Lisa Lovse  1   2 , Allison M Cracchiolo  1 , Shariff K Bishai  5 , Chaoyang Chen  1 , Stephen E Lemos  1   2
Affiliations

Anatomic Acromioclavicular Joint Reconstruction with and without Acromioclavicular Ligament Reconstruction: A Comparative Biomechanical Study

Steven M Johnson et al. Shoulder Elbow. 2023 Apr.

Abstract

Background: The purpose of this study was to determine if adding a reconstructed superior acromioclavicular (AC) joint ligament adds significant biomechanical stability to the AC joint over anatomic coracoclavicular (CC) ligament reconstruction alone.

Methods: Fourteen cadaver shoulders were used for the comparison of biomechanical stability among the anatomic CC ligament reconstruction alone, CC and AC ligament reconstruction, and the intact groups by measuring the displacement under cyclic loads. A load to failure test was then performed in the vertical direction at a loading rate of 2 mm /sec to determine surgical-repair joints' tolerance to the maximum failure load.

Results: The average peak-to-peak displacement induced by cyclic load in the sagittal axis and vertical axis direction was not significantly different between CC ligament reconstruction, CC and AC ligament reconstruction, and intact groups. The maximum failure load for the CC reconstruction (224.9 ± 91.8 N (Mean ± SEM)) was lower than CC/AC reconstruction groups (326.2 ± 123.3 N). The CC/AC reconstruction group failed at a significantly higher load (t test, p = 0.016) than the CC reconstruction group.

Conclusion: CC/AC reconstruction surgical technique yielded a better shoulder stability than CC ligament alone reconstruction that may better maintain reduction of the AC joint.Level of Evidence: Level II.

Keywords: acromioclavicular joint; biomechanics; coracoclavicular ligament; injury; reconstruction.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Biomechanical testing setup of a cadaveric shoulder mounted on the instron material testing machine. The scapula and medial end of the clavicle were potted in two adjustable fixtures respectively using a polyester resin material. The glenoid was used as a reference being horizontal for posterior load testing and vertical for superior load testing.
Figure 2.
Figure 2.
A shows the experimental setting of anatomic CC ligament reconstruction. B shows the dimension of holes drilled for reconstruction. C shows the schematic illustration of anatomic CC ligament reconstruction pathway.
Figure 3.
Figure 3.
A shows the experimental setting of anatomic CC plus AC ligament reconstruction. B shows the dimension of holes drilled for reconstruction. C shows the schematic illustration of anatomic CC and AC ligament reconstruction pathway.
Figure 4.
Figure 4.
Peak to peak displacement under cyclic load. Vertical load caused more displacement than anterior-posterior (AP) direction load.
See this image and copyright information in PMC

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