Biomechanical comparison of double versus triple button reconstruction techniques in patients with acromioclavicular joint dislocation

Abstract

Background: Although many techniques are used to treat the acromioclavicular (AC) joint dislocations, minimal invasive or arthroscopic coracoclavicular ligament reconstructions became popular recently. In this study, authors compared the biomechanical results of double versus triple button reconstruction techniques.Methods: Three-dimensional solid modeling of the shoulder girdle was carried out using virtual finite element modeling. AC joint dislocation was applied to the reference model, and these models were repaired by double and triple button techniques, respectively. Maximum equivalent stresses on buttons and sutures as well as displacements and reaction forces on AC joint were evaluated. Results: Triple button model was more stable during flexion and abduction when compared with double button technique. Conclusion: Mimicking conoid ligament has a crucial mission more particularly against resistance during frontal plane actions, but the absence of the trapezoid ligament causes increasing the posterior displacement of the distal clavicle during the flexion of GH joint. K E Y W O R D S acromioclavicular joint, button, finite element model, scapula, shoulder

Reconstruction of Coracoclavicular Ligament with Endobutton and Sutures to Stabilize Acromioclavicular Joint: A Retrospective Clinical Study and Finite Element Analysis

“…We have demonstrated that acromioclavicular ligament augmentation repair combined with coracoclavicular ligament mini plate suspension xation is more stable than coracoclavicular ligament mini plate suspension xation alone. This result is consistent with the results of multiple nite element analysisrelated literatures (11)(12)(13). The nite element analysis study supported and validated our clinical research conclusions from three aspects: 1.…”

“…At present, it remains controversy regarding the clinical application of Endobutton plate suspension surgery for the reduction of acromioclavicular dislocation. Through computer simulation of nite element analysis combined with biomechanical research, many scholars consider that additional augmentation suture repair of acromioclavicular ligament after reconstruction of coracoclavicular ligament can signi cantly improve the postoperative posterior displacement and rotation stability of acromioclavicular joint (11)(12)(13). However, some researchers carried out biomechanical analysis of cadaveric specimens simulating surgically treated acromioclavicular joint dislocation, and found that the effect of an additional acromioclavicular cerclage on the stability of acromioclavicular joint seemed to be negligible (14).…”

Comparison of two surgical techniques for the treatment of transverse olecranon fractures: A finite element study

“…Ti6Al4V, the most common material properties, was chosen for K‐wire, intramedullary screw and tension band. The mechanical properties of the materials are shown in Table 1 21–25 …”

Novel Double Endobutton Technique Combined with Three‐Dimensional Printing: A Biomechanical Study of Reconstruction in Acromioclavicular Joint Dislocation

“…However, none of the groups in this study reached the ultimate load reported in the literature. This could be due to the bone-ligament-bone structure includes the properties of the clavicle and coracoid, and the clavicle stiffness would be reduced by 40% after dislocation [36][37][38][39] .…”