Acromioclavicular Joint Stabilization: A Biomechanical Study of Bidirectional Stability and Strength

Abstract:
Background: It is important to restore horizontal and vertical stability to the acromioclavicular (AC) joint when treating dislocations of this joint. Most surgical stabilization techniques of the AC joint have primarily addressed the coracoclavicular ligament complex; however, these techniques may not satisfactorily restore horizontal stability to the AC joint. Purpose: To evaluate the strength and bidirectional stability of 3 AC joint stabilizing techniques in a cadaveric model. Study Design: Controlled laboratory study. Methods: A total of 24 cadaveric shoulders were randomly allocated to 3 treatment groups. For each group, a standardized AC joint stabilizing procedure was performed, and the specimens were potted for mechanical testing. The following reconstruction techniques were used: a single clavicular tunnel for group A, a double clavicular tunnel for group B, and a double clavicular tunnel plus suture fixation across the AC joint for group C. The specimens underwent cyclic loading in the horizontal and vertical planes and then load to failure. Eight control specimens also underwent cyclic loading in both planes. Construct stiffness during cyclic loading, change in displacement after cyclic loading in both planes, load to failure in the vertical plane, and mode of failure were evaluated, and stiffness was compared among the treatment groups as well as with a control group. Results: There was a decrease in joint stiffness for all groups, including controls, during the cyclic loading. Compared with controls, all 3 treatment groups demonstrated equivalent stiffness and displacement in the vertical plane. In the horizontal plane, all 3 treatment groups demonstrated decreased stiffness, increased displacement, or both when compared with controls. When groups were compared, no treatment arm proved superior regarding stiffness or displacement in either plane. Load-to-failure testing of the 3 treatment groups in the vertical plane demonstrated construct strength and stiffness comparable with reports for the native AC joint. The mode of failure was predominantly fracture at the point of fixation to the testing apparatus. Conclusion: There was no difference in bidirectional strength and stability between the single– and double–clavicular tunnel techniques of coracoclavicular reconstruction. The addition of a stabilizing suture across the AC joint does not improve horizontal stability in the absence of repair of the AC joint capsule and deltotrapezial fascia. Clinical Relevance: This laboratory study provides further evidence of the importance of the AC joint capsule and associated soft tissues in affording horizontal stability to that joint. Information from this and subsequent studies utilizing a bidirectional model can influence the choice of surgical procedure in the clinical treatment of AC joint dislocations.
Author Listing： Patrick Hislop;Kentaro Sakata;David C. Ackland;Robert Gotmaker;Matthew C. Evans
Volume： 7
Pages： None
DOI： 10.1177/2325967119836751
Language： English
Journal： Orthopaedic Journal of Sports Medicine

Orthopaedic Journal of Sports Medicine

ORTHOP J SPORTS MED

影响因子：2.4 是否综述期刊：否 是否OA：是 是否预警：不在预警名单内 发行时间：- ISSN：2325-9671 发刊频率：- 收录数据库：SCIE/Scopus收录/DOAJ开放期刊 出版国家/地区：United States 出版社：SAGE

期刊介绍

The Orthopaedic Journal of Sports Medicine (OJSM), developed by the American Orthopaedic Society for Sports Medicine (AOSSM), is a global, peer-reviewed, open access journal that combines the interests of researchers and clinical practitioners across orthopaedic sports medicine, arthroscopy, and knee arthroplasty. Topics include original research in the areas of:-Orthopaedic Sports Medicine, including surgical and nonsurgical treatment of orthopaedic sports injuries-Arthroscopic Surgery (Shoulder/Elbow/Wrist/Hip/Knee/Ankle/Foot)-Relevant translational research-Sports traumatology/epidemiology-Knee and shoulder arthroplastyThe OJSM also publishes relevant systematic reviews and meta-analyses. This journal is a member of the Committee on Publication Ethics (COPE).

《骨科运动医学杂志》（OJSM）由美国骨科运动医学学会（AOSSM）开发，是一本全球性、同行评审、开放获取的期刊，结合了骨科运动医学、关节镜检查和膝关节置换术研究人员和临床从业者的兴趣。主题包括以下领域的原创研究：-骨科运动医学，包括骨科运动损伤的手术和非手术治疗-关节镜手术（肩/肘/腕/髋/膝/踝/足）-相关转化研究-运动创伤学/流行病学-膝关节和肩关节成形术OJSM还发表相关系统综述和荟萃分析。该杂志是出版伦理委员会（科普）的成员。

年发文量 423
国人发稿量 39
国人发文占比 9.22%
自引率 8.3%
平均录取率 -
平均审稿周期 12 Weeks
版面费 -
偏重研究方向 Medicine-Orthopedics and Sports Medicine
期刊官网 https://journals.sagepub.com/home/ojs
投稿链接 https://us.sagepub.com/en-us/nam/journal/orthopaedic-journal-sports-medicine#submission-guidelines

质量指标占比

研究类文章占比 OA被引用占比 撤稿占比 出版后修正文章占比
87.47% 91.23% - -

相关指数

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