Evaluation of the clavicular tunnel placement on coracoclavicular ligament reconstruction for acromioclavicular dislocations: a finite element analysis

Kocadal, Onur; Yuksel, Korcan; Güven, Melih

doi:10.1007/s00264-018-3789-y

Cited by 5 publications

(2 citation statements)

References 24 publications

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“…Second, the position of the clavicular tunnel and the coracoid tunnel needed accurate location. The loadings on the Ethibond sutures may be related to the tunnel placement [18]. The ratio of the distance from the lateral border of the clavicle to the trapezoid ligament center to clavicular length (CL) was 17.6%, and the ratio of the distance from the lateral border of the clavicle to the conoid ligament center to clavicular length (CL) was 23.8% in one anatomic study [19].…”

Section: Discussionmentioning

confidence: 99%

Anchor moored positioning technique by suture anchor and Endobutton fixation for treatment of acromioclavicular joint dislocation

Ying¹,

Shen²,

Wang³

2019

Preprint

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Background Numerous surgical methods have been used for acromioclavicular joint reconstruction.In this study, we analyzed the clinical and radiographic outcomes of truly anatomic coracoclavicular ligaments reconstruction (TACCR) and truly anatomic acromioclavicular ligaments reconstruction (TAACR) using suture anchor and Endobutton fixation for treatment of acromioclavicular joint dislocation. Methods 48 patients (mean age 49 years) with severe acromioclavicular joint dislocation. The patients were classified as Rockwood type III (n=28), IV (n=3) and V (n=17). All patients were operatively treated using anchor moored positioning technique by suture anchor and Endobutton fixation. Clinical and radiographic evaluation include the visual analog scale (VAS), Constant scores (CS) and American Shoulder and Elbow Surgeons (ASES) scores and radiographic outcomes. Results The mean follow-up was 34 months. The VAS decreased from 5 preoperatively to 0 at 24 months (P < .001). The CS and ASES scores improved from 43, 44 preoperatively to 96, 97 at 24 months separately (P < .001). Meanwhile, 47 patients (97.9%) demonstrated stable anatomical fixation on final postoperative radiographs. Loss of reduction occurred in 1 patient (2.1%), but was not correlated with functional outcome. Conclusions Anchor moored positioning technique with Bi-directional fixations by suture anchor and Endobutton fixation represents a new and reliable treatment of AC joint dislocation.

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Section: Discussionmentioning

confidence: 99%

Anchor moored positioning technique by suture anchor and Endobutton fixation for treatment of acromioclavicular joint dislocation

Ying¹,

Shen²,

Wang³

2019

Preprint

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“…The sternal articular surface of the clavicle and the inferior surface of the acromion were determined for the boundary conditions (Fig. 5 ) [ 3 , 13 , 16 , 17 ]. The FiberWire was bonded with buttons (TIE).…”

Section: Methodsmentioning

confidence: 99%

Evaluation of the coracoid bone tunnel placement on Dog Bone™ button fixation for acromioclavicular joint dislocation: a cadaver study combined with finite element analysis

Gao

Zhang

Yang

et al. 2023

BMC Musculoskelet Disord

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Background Dog Bone™ button fixation is frequently used to treat acromioclavicular joint (ACJ) dislocation. However, various studies have reported complications after fixation. Objective To investigate the effect of the coracoid bone tunnel location on the treatment of ACJ dislocation through single-tunnel coracoclavicular (CC) ligament fixation with the Dog Bone™ button. Methods Six cadaveric shoulders were used. Each specimen was subjected to five testing conditions in the following order: (1) normal ACJ (Gn); (2) acromioclavicular and CC ligaments were removed (G0); (3) CC ligament reconstruction was performed using the Dog Bone™ technique, and the coracoid bone tunnel was at the center of the coracoid base (G1); (4) reconstruction was performed at 5 mm distal from the G1 site, along the axis of the coracoid (G2); (5) reconstruction was performed at 10 mm distal from the G1 site, along the axis of the coracoid (G3). The angles of pronation and supination of the clavicle under the same load (30 N) were measured. Next, a finite element (FE) model was created using computed tomography (CT) images of the normal shoulder. Model 1 (M1), model 2 (M2), and model 3 (M3) correspond to G1, G2, and G3, respectively. A force of 70 N was applied as a vertical upward load to the distal clavicle. Subsequently, the von Mises stress, the strain LE along the FiberWire, and the displacement nephogram of the three models were obtained. Results After single-tunnel CC ligament fixation using the Dog Bone™ technique, the clavicle in the G2 group (20.50 (19.50, 21.25) °, 20.00 (18.75, 21.25) °) had the best rotational stability. The peak von Mises stress, the strain LE along the FiberWire, and the maximum displacement were smaller in M2 than in M1 and M3. Conclusions When the coracoid bone tunnel was located 5 mm anterior to the center of the coracoid base (along the axis of the coracoid), the clavicle showed greater rotational stability.

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Clavicular Tunnel Widening After Acromioclavicular Stabilization Shows Implant-Dependent Correlation With Postoperative Loss of Reduction

Bellmann

Eckl

Vetter

et al. 2023

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Evaluation of the clavicular tunnel placement on coracoclavicular ligament reconstruction for acromioclavicular dislocations: a finite element analysis

Abstract: In two-tunnel CLR technique, tendon loadings are related to tunnel placement. Medialized tunnel placement increases tendon loading. The TR method may be an appropriate option for determining tunnel placement.

Cited by 5 publications

References 24 publications

Anchor moored positioning technique by suture anchor and Endobutton fixation for treatment of acromioclavicular joint dislocation

Anchor moored positioning technique by suture anchor and Endobutton fixation for treatment of acromioclavicular joint dislocation

Evaluation of the coracoid bone tunnel placement on Dog Bone™ button fixation for acromioclavicular joint dislocation: a cadaver study combined with finite element analysis

Clavicular Tunnel Widening After Acromioclavicular Stabilization Shows Implant-Dependent Correlation With Postoperative Loss of Reduction

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