Acromioclavicular and coracoclavicular PDS augmentation for complete AC joint dislocation showed insufficient properties in a cadaver model View Full Text


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Article Info

DATE

2012-05-31

AUTHORS

Frank Martetschläger, Arne Buchholz, Gunther Sandmann, Sebastian Siebenlist, Stefan Döbele, Alexander Hapfelmeier, Ulrich Stöckle, Peter J. Millett, Florian Elser, Andreas Lenich

ABSTRACT

PurposeOptimal surgical treatment of high-grade acromioclavicular joint dislocations is still controversially discussed. The purpose of the present controlled laboratory study was to evaluate whether a polydioxansulfate (PDS®) cord augmentation with separate reconstruction of the coracoclavicular (CC) ligaments and the acromioclavicular (AC) complex provides sufficient vertical stability in a biomechanical cadaver model.MethodsTwenty-four shoulders of fresh-frozen cadaveric specimen were tested. Cyclic loading and load to failure protocol was performed in vertical direction on 12 native AC joints and repeated after reconstruction. The reconstruction of the coracoclavicular ligament was performed using two CC PDS cerclages and an additional AC PDS cerclage.ResultsIn static load testing for vertical force, the native AC joint complex measured 590.1 N (±95.8 N), elongation 13.4 mm (±2.1 mm) and stiffness 48.7 N/mm (±12.0 N/mm). The mean maximum load to failure in the reconstructed joints was 569.9 N (±97.9 N), elongation 18.8 mm (±4.7 mm) and stiffness 37.9 N/mm (±8.0 N/mm). During dynamic testing of the reconstructed AC joints, all specimens reached the critical elongation of 12.0 mm, defined as clinical failure between 200 and 300 N. The mean amount of repetitions at clinical failure was 305. A plastic deformation of the reconstructed specimens throughout cyclic loading could not be detected.ConclusionThe AC joint reconstruction with acromioclavicular and coracoclavicular PDS cord cerclages did not provide the aspired vertical stability in a cadaver model.Level of evidenceBasic Science Study. More... »

PAGES

438-444

References to SciGraph publications

  • 2009-05-09. Mid-term outcome comparing temporary K-wire fixation versus PDS augmentation of Rockwood grade III acromioclavicular joint separations in BMC RESEARCH NOTES
  • 2009-06-25. Arthroscopic treatment of acute acromioclavicular joint dislocation with double flip button in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2005-11-10. A novel treatment of grade III acromioclavicular joint dislocations with a C-hook implant in ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY
  • 1999-11. Which stabilization technique corrects anatomy best in patients with AC-separation? An experimental study in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2005-12-23. Minimally invasive endoscopic reconstruction technique of acute AC-joint dislocations: a cadaver study in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2011-02-24. Mid-term results after operative treatment of rockwood grade III-V Acromioclavicular joint dislocations with an AC-hook-plate in EUROPEAN JOURNAL OF MEDICAL RESEARCH
  • 2005-12-08. Arthroscopic reconstruction of the acromioclavicular joint disruption: surgical technique and preliminary results in ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY
  • 2008-07-04. Mid to long-term results of open acromioclavicular-joint reconstruction using polydioxansulfate cerclage augmentation in ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY
  • 2008-10-03. Arthroscopic reconstruction of chronic AC joint dislocations by transposition of the coracoacromial ligament augmented by the Tight Rope device: a technical note in KNEE SURGERY, SPORTS TRAUMATOLOGY, ARTHROSCOPY
  • 2009-01-14. Acromioclavicular joint reconstruction with coracoacromial ligament transfer using the docking technique in BMC MUSCULOSKELETAL DISORDERS
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00167-012-2067-6

    DOI

    http://dx.doi.org/10.1007/s00167-012-2067-6

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1023372128

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/22648748


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    29 schema:description PurposeOptimal surgical treatment of high-grade acromioclavicular joint dislocations is still controversially discussed. The purpose of the present controlled laboratory study was to evaluate whether a polydioxansulfate (PDS®) cord augmentation with separate reconstruction of the coracoclavicular (CC) ligaments and the acromioclavicular (AC) complex provides sufficient vertical stability in a biomechanical cadaver model.MethodsTwenty-four shoulders of fresh-frozen cadaveric specimen were tested. Cyclic loading and load to failure protocol was performed in vertical direction on 12 native AC joints and repeated after reconstruction. The reconstruction of the coracoclavicular ligament was performed using two CC PDS cerclages and an additional AC PDS cerclage.ResultsIn static load testing for vertical force, the native AC joint complex measured 590.1 N (±95.8 N), elongation 13.4 mm (±2.1 mm) and stiffness 48.7 N/mm (±12.0 N/mm). The mean maximum load to failure in the reconstructed joints was 569.9 N (±97.9 N), elongation 18.8 mm (±4.7 mm) and stiffness 37.9 N/mm (±8.0 N/mm). During dynamic testing of the reconstructed AC joints, all specimens reached the critical elongation of 12.0 mm, defined as clinical failure between 200 and 300 N. The mean amount of repetitions at clinical failure was 305. A plastic deformation of the reconstructed specimens throughout cyclic loading could not be detected.ConclusionThe AC joint reconstruction with acromioclavicular and coracoclavicular PDS cord cerclages did not provide the aspired vertical stability in a cadaver model.Level of evidenceBasic Science Study.
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    42 MethodsTwenty-four shoulders
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    46 PurposeOptimal surgical treatment
    47 ResultsIn static load
    48 acromioclavicular (AC) complex
    49 acromioclavicular joint dislocation
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