Anatomical acromioclavicular ligament reconstruction: A biomechanical comparison of reconstructive techniques of the acromioclavicular joint

Paul W. Grutter, Steve Petersen

Research output: Contribution to journalArticle

Abstract

Background: Current surgical treatments for acromioclavicular separations do not re-create the anatomy of the acromioclavicular joint. Hypothesis: Anatomical acromioclavicular reconstruction re-creates the strength of the native acromioclavicular joint and is stronger than a modified Weaver-Dunn repair. Study Design: Controlled laboratory study. Methods: The native acromioclavicular joint in 6 fresh-frozen cadaveric upper extremities was stressed to failure under uniaxial tension in the coronal plane. A modified Weaver-Dunn procedure, anatomical acromioclavicular reconstruction using a palmaris longus graft, and anatomical acromioclavicular reconstruction using a flexor carpi radialis graft were then performed sequentially. Each repair was stressed to failure. Load-displacement curves and mechanism of failure were recorded for each. Results: Loads at failure for the native acromioclavicular joint complex, modified Weaver-Dunn procedure, anatomical acromioclavicular reconstruction using a palmaris longus tendon graft, and anatomical acromioclavicular reconstruction using a flexor carpi radialis tendon graft were 815 N, 483 N, 326 N, and 774 N, respectively. The strength of the native acromioclavicular joint complex was significantly different from the modified Weaver-Dunn repair (P <.001) and the anatomical acromioclavicular reconstruction using a palmaris longus tendon graft (P <.001) but not from the anatomical acromioclavicular reconstruction using a flexor carpi radialis tendon graft (P = .607). Conclusion: The strength of the described anatomical acromioclavicular reconstruction is limited by the tendon graft used. Anatomical acromioclavicular reconstruction with a flexor carpi radialis tendon graft re-creates the tensile strength of the native acromioclavicular joint complex and is superior to a modified Weaver-Dunn repair.

Original languageEnglish (US)
Pages (from-to)1723-1728
Number of pages6
JournalAmerican Journal of Sports Medicine
Volume33
Issue number11
DOIs
StatePublished - Nov 2005

Fingerprint

Acromioclavicular Joint
Ligaments
Tendons
Transplants
Tensile Strength
Upper Extremity
Anatomy

Keywords

  • Acromioclavicular joint
  • Biomechanics
  • Ligaments
  • Reconstruction
  • Shoulder

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

@article{82e28dc3bcc8495a9607c9325bf9924a,
title = "Anatomical acromioclavicular ligament reconstruction: A biomechanical comparison of reconstructive techniques of the acromioclavicular joint",
abstract = "Background: Current surgical treatments for acromioclavicular separations do not re-create the anatomy of the acromioclavicular joint. Hypothesis: Anatomical acromioclavicular reconstruction re-creates the strength of the native acromioclavicular joint and is stronger than a modified Weaver-Dunn repair. Study Design: Controlled laboratory study. Methods: The native acromioclavicular joint in 6 fresh-frozen cadaveric upper extremities was stressed to failure under uniaxial tension in the coronal plane. A modified Weaver-Dunn procedure, anatomical acromioclavicular reconstruction using a palmaris longus graft, and anatomical acromioclavicular reconstruction using a flexor carpi radialis graft were then performed sequentially. Each repair was stressed to failure. Load-displacement curves and mechanism of failure were recorded for each. Results: Loads at failure for the native acromioclavicular joint complex, modified Weaver-Dunn procedure, anatomical acromioclavicular reconstruction using a palmaris longus tendon graft, and anatomical acromioclavicular reconstruction using a flexor carpi radialis tendon graft were 815 N, 483 N, 326 N, and 774 N, respectively. The strength of the native acromioclavicular joint complex was significantly different from the modified Weaver-Dunn repair (P <.001) and the anatomical acromioclavicular reconstruction using a palmaris longus tendon graft (P <.001) but not from the anatomical acromioclavicular reconstruction using a flexor carpi radialis tendon graft (P = .607). Conclusion: The strength of the described anatomical acromioclavicular reconstruction is limited by the tendon graft used. Anatomical acromioclavicular reconstruction with a flexor carpi radialis tendon graft re-creates the tensile strength of the native acromioclavicular joint complex and is superior to a modified Weaver-Dunn repair.",
keywords = "Acromioclavicular joint, Biomechanics, Ligaments, Reconstruction, Shoulder",
author = "Grutter, {Paul W.} and Steve Petersen",
year = "2005",
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language = "English (US)",
volume = "33",
pages = "1723--1728",
journal = "American Journal of Sports Medicine",
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T2 - A biomechanical comparison of reconstructive techniques of the acromioclavicular joint

AU - Grutter, Paul W.

AU - Petersen, Steve

PY - 2005/11

Y1 - 2005/11

N2 - Background: Current surgical treatments for acromioclavicular separations do not re-create the anatomy of the acromioclavicular joint. Hypothesis: Anatomical acromioclavicular reconstruction re-creates the strength of the native acromioclavicular joint and is stronger than a modified Weaver-Dunn repair. Study Design: Controlled laboratory study. Methods: The native acromioclavicular joint in 6 fresh-frozen cadaveric upper extremities was stressed to failure under uniaxial tension in the coronal plane. A modified Weaver-Dunn procedure, anatomical acromioclavicular reconstruction using a palmaris longus graft, and anatomical acromioclavicular reconstruction using a flexor carpi radialis graft were then performed sequentially. Each repair was stressed to failure. Load-displacement curves and mechanism of failure were recorded for each. Results: Loads at failure for the native acromioclavicular joint complex, modified Weaver-Dunn procedure, anatomical acromioclavicular reconstruction using a palmaris longus tendon graft, and anatomical acromioclavicular reconstruction using a flexor carpi radialis tendon graft were 815 N, 483 N, 326 N, and 774 N, respectively. The strength of the native acromioclavicular joint complex was significantly different from the modified Weaver-Dunn repair (P <.001) and the anatomical acromioclavicular reconstruction using a palmaris longus tendon graft (P <.001) but not from the anatomical acromioclavicular reconstruction using a flexor carpi radialis tendon graft (P = .607). Conclusion: The strength of the described anatomical acromioclavicular reconstruction is limited by the tendon graft used. Anatomical acromioclavicular reconstruction with a flexor carpi radialis tendon graft re-creates the tensile strength of the native acromioclavicular joint complex and is superior to a modified Weaver-Dunn repair.

AB - Background: Current surgical treatments for acromioclavicular separations do not re-create the anatomy of the acromioclavicular joint. Hypothesis: Anatomical acromioclavicular reconstruction re-creates the strength of the native acromioclavicular joint and is stronger than a modified Weaver-Dunn repair. Study Design: Controlled laboratory study. Methods: The native acromioclavicular joint in 6 fresh-frozen cadaveric upper extremities was stressed to failure under uniaxial tension in the coronal plane. A modified Weaver-Dunn procedure, anatomical acromioclavicular reconstruction using a palmaris longus graft, and anatomical acromioclavicular reconstruction using a flexor carpi radialis graft were then performed sequentially. Each repair was stressed to failure. Load-displacement curves and mechanism of failure were recorded for each. Results: Loads at failure for the native acromioclavicular joint complex, modified Weaver-Dunn procedure, anatomical acromioclavicular reconstruction using a palmaris longus tendon graft, and anatomical acromioclavicular reconstruction using a flexor carpi radialis tendon graft were 815 N, 483 N, 326 N, and 774 N, respectively. The strength of the native acromioclavicular joint complex was significantly different from the modified Weaver-Dunn repair (P <.001) and the anatomical acromioclavicular reconstruction using a palmaris longus tendon graft (P <.001) but not from the anatomical acromioclavicular reconstruction using a flexor carpi radialis tendon graft (P = .607). Conclusion: The strength of the described anatomical acromioclavicular reconstruction is limited by the tendon graft used. Anatomical acromioclavicular reconstruction with a flexor carpi radialis tendon graft re-creates the tensile strength of the native acromioclavicular joint complex and is superior to a modified Weaver-Dunn repair.

KW - Acromioclavicular joint

KW - Biomechanics

KW - Ligaments

KW - Reconstruction

KW - Shoulder

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