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Sagittal orientation of coracoclavicular ligament reconstruction affects the stability of surgical repair
- Source :
- Journal of shoulder and elbow surgery. 29(9)
- Publication Year :
- 2019
-
Abstract
- BACKGROUND The variation in the anatomic relationship between the coracoid and the clavicle affects the biomechanical stability of coracoclavicular ligament reconstruction (CCLR). METHODS Three-dimensional computed tomography reconstruction of 85 patients was analyzed. Anatomic landmarks were used to derive the coracoclavicular sagittal reconstruction angle (sRA). The lateral concave angle, which indicated the shape of the distal clavicle, and the offsets between the clavicle and coracoid were also measured. To investigate the biomechanical effects of the sRA on CCLR, 7 computed tomography scans with different sRAs were 3D printed. Two reconstructions, a single trans-coracoclavicular tunnel and a looped reconstruction technique, were performed sequentially. Models were cyclically loaded at 70 N in the anterior, posterior, and superior directions. RESULTS The mean sRA was 68° ± 9.3° (range, 47°-85°). The superoinferior offset between the clavicle and the coracoid and the lateral concave angle positively correlated with the sRA (r = 0.359 and 0.837, respectively; P ≤ .001), whereas the anteroposterior offset had a negative correlation (r = -0.925; P < .001). The sRA had a negative correlation with the anterior displacement of the clavicle (rho = -0.96; P < .001) and a positive correlation with the posterior displacement for both surgical techniques (rho = 1.0; P < .001). CONCLUSION The anatomic orientation of the native coracoclavicular ligaments is highly variable in the sagittal plane. Low sagittal angles can reduce anterior stability, whereas high sagittal angles can reduce posterior stability of CCLR.
- Subjects :
- Male
Models, Anatomic
Coracoid
Superoinferior
03 medical and health sciences
0302 clinical medicine
Imaging, Three-Dimensional
Orientation (geometry)
medicine
Cadaver
Acromioclavicular joint
Humans
Orthopedics and Sports Medicine
Coracoclavicular ligament
Aged
030222 orthopedics
business.industry
Shoulder Joint
Biomechanics
030229 sport sciences
General Medicine
Anatomy
Middle Aged
Clavicle
Sagittal plane
Biomechanical Phenomena
medicine.anatomical_structure
Ligaments, Articular
Printing, Three-Dimensional
Surgery
Female
Anatomic Landmarks
business
Tomography, X-Ray Computed
Subjects
Details
- ISSN :
- 15326500
- Volume :
- 29
- Issue :
- 9
- Database :
- OpenAIRE
- Journal :
- Journal of shoulder and elbow surgery
- Accession number :
- edsair.doi.dedup.....e72da5e3a70eba20d22458d79d7bf93c