Biomechanical analysis of acromioclavicular joint dislocation repair using coracoclavicular suspension devices in two different configurations.
BACKGROUND
The best treatment option for some acromioclavicular (AC) joint dislocations is controversial. For this reason, the aim of this study was to evaluate the vertical biomechanical behavior of two techniques for the anatomic repair of coracoclavicular (CC) ligaments after an AC injury.


METHODS
Eighteen human cadaveric shoulders in which repair using a coracoclavicular suspension device was initiated after injury to the acromioclavicular joint were included in the study. Three groups were formed; group I (n = 6): control; group II (n = 6): repair with a double tunnel in the clavicle and in the coracoid (with two CC suspension devices); group III (n = 6): repair in a "V" configuration with two tunnels in the clavicle and one in the coracoid (with one CC suspension device). The biomechanical study was performed with a universal testing machine (Electro Puls 3000, Instron, Boulder, MA, USA), with the clamping jaws set in a vertical position. The force required for acromioclavicular reconstruction system failure was analyzed for each cadaveric piece.


RESULTS
Group I reached a maximum force to failure of 635.59 N (mean 444.0 N). The corresponding force was 939.37 N (mean 495.6 N) for group II and 533.11 N (mean 343.9 N) for group III. A comparison of the three groups did not find any significant difference despite the loss of resistance presented by group III.


CONCLUSIONS
Anatomic repair of coracoclavicular ligaments with a double system (double tunnel in the clavicle and in the coracoid) permits vertical translation that is more like that of the acromioclavicular joint. Acromioclavicular repair in a "V" configuration does not seem to be biomechanically sufficient.
Department of Sports Orthopaedics, ReSport Clinic, Barcelona, Spain, ferranabat@gmail.com.
Ferran
F
Abat
Juan
J
Sarasquete
Luis Gerardo
LG
Natera
Ángel
Á
Calvo
Manuel
M
Pérez-España
Néstor
N
Zurita
Jesús
J
Ferrer
Juan Carlos
JC
del Real
Eva
E
Paz-Jimenez
Francisco
F
Forriol
D000173:Acromioclavicular Joint / Q000293:injuries* / Q000503:physiopathology*; D000328:Adult; D001178:Arthroplasty / Q000295:instrumentation*; D002102:Cadaver; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery*; D008023:Ligaments, Articular / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged