BACKGROUND: Reconstruction for injuries to the acromioclavicular joint remains controversial. HYPOTHESIS: A coracoclavicular ligament reconstruction with a semitendinosus tendon would have superior performance to the classic coracoacromial ligament transfer with or without augmentation. STUDY DESIGN: Controlled laboratory study. METHODS: Five cadaveric shoulders were used to reconstruct the coracoclavicular ligaments with 3 methods: coracoacromial ligament transfer without augmentation, coracoacromial ligament transfer augmented with No. 5 Ethibond suture, and a semitendinosus tendon. Each reconstruction was cyclically loaded at 40 N to 80 N for 2500 cycles, then from 40 N to 210 N for 2500 cycles, followed by loading to failure. The number of cycles to 50% and 100% loss of acromioclavicular joint reduction were recorded. RESULTS: During the 40 N to 80 N-loading cycle, the coracoacromial transfer without augmentation failed (15 +/- 16 cycles). The augmented coracoacromial ligament transfer and the semitendinosus reconstruction did not fail (P = .008). During the 40 N to 210 N-loading cycle, the augmented coracoacromial ligament transfer failed (207 +/- 399 cycles). The semitendinosus reconstruction survived through both loading cycles (P < .01). CONCLUSION: Coracoclavicular ligament reconstruction with a semitendinosus graft is a biomechanically superior construct in a cyclically loaded setting to a coracoacromial ligament transfer augmented with a No. 5 Ethibond suture. CLINICAL RELEVANCE: The semitendinosus graft is a strong, biologic option for reconstruction of the coracoclavicular ligaments.
BACKGROUND: Reconstruction for injuries to the acromioclavicular joint remains controversial. HYPOTHESIS: A coracoclavicular ligament reconstruction with a semitendinosus tendon would have superior performance to the classic coracoacromial ligament transfer with or without augmentation. STUDY DESIGN: Controlled laboratory study. METHODS: Five cadaveric shoulders were used to reconstruct the coracoclavicular ligaments with 3 methods: coracoacromial ligament transfer without augmentation, coracoacromial ligament transfer augmented with No. 5 Ethibond suture, and a semitendinosus tendon. Each reconstruction was cyclically loaded at 40 N to 80 N for 2500 cycles, then from 40 N to 210 N for 2500 cycles, followed by loading to failure. The number of cycles to 50% and 100% loss of acromioclavicular joint reduction were recorded. RESULTS: During the 40 N to 80 N-loading cycle, the coracoacromial transfer without augmentation failed (15 +/- 16 cycles). The augmented coracoacromial ligament transfer and the semitendinosus reconstruction did not fail (P = .008). During the 40 N to 210 N-loading cycle, the augmented coracoacromial ligament transfer failed (207 +/- 399 cycles). The semitendinosus reconstruction survived through both loading cycles (P < .01). CONCLUSION: Coracoclavicular ligament reconstruction with a semitendinosus graft is a biomechanically superior construct in a cyclically loaded setting to a coracoacromial ligament transfer augmented with a No. 5 Ethibond suture. CLINICAL RELEVANCE: The semitendinosus graft is a strong, biologic option for reconstruction of the coracoclavicular ligaments.
Authors: Frank Martetschläger; Arne Buchholz; Gunther Sandmann; Sebastian Siebenlist; Stefan Döbele; Alexander Hapfelmeier; Ulrich Stöckle; Peter J Millett; Florian Elser; Andreas Lenich Journal: Knee Surg Sports Traumatol Arthrosc Date: 2012-05-31 Impact factor: 4.342
Authors: Tim Saier; Arne J Venjakob; Philipp Minzlaff; Peter Föhr; Filip Lindell; Andreas B Imhoff; Stephan Vogt; Sepp Braun Journal: Knee Surg Sports Traumatol Arthrosc Date: 2014-02-21 Impact factor: 4.342
Authors: Sang-Jin Shin; Sean Campbell; Jonathan Scott; Michelle H McGarry; Thay Q Lee Journal: Knee Surg Sports Traumatol Arthrosc Date: 2013-07-11 Impact factor: 4.342