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Acromioclavicular joint dislocations: coracoclavicular reconstruction with and without additional direct acromioclavicular repair

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Acromioclavicular joint dislocations: coracoclavicular reconstruction with and without additional direct acromioclavicular repair. / Weiser, Lukas; Nüchtern, Jakob V; Sellenschloh, Kay; Püschel, Klaus; Morlock, Michael M; Rueger, Johannes M; Hoffmann, Michael; Lehmann, Wolfgang; Großterlinden, Lars G.

In: KNEE SURG SPORT TR A, Vol. 25, No. 7, 07.2017, p. 2025-2031.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Weiser, L, Nüchtern, JV, Sellenschloh, K, Püschel, K, Morlock, MM, Rueger, JM, Hoffmann, M, Lehmann, W & Großterlinden, LG 2017, 'Acromioclavicular joint dislocations: coracoclavicular reconstruction with and without additional direct acromioclavicular repair', KNEE SURG SPORT TR A, vol. 25, no. 7, pp. 2025-2031. https://doi.org/10.1007/s00167-015-3920-1

APA

Weiser, L., Nüchtern, J. V., Sellenschloh, K., Püschel, K., Morlock, M. M., Rueger, J. M., Hoffmann, M., Lehmann, W., & Großterlinden, L. G. (2017). Acromioclavicular joint dislocations: coracoclavicular reconstruction with and without additional direct acromioclavicular repair. KNEE SURG SPORT TR A, 25(7), 2025-2031. https://doi.org/10.1007/s00167-015-3920-1

Vancouver

Weiser L, Nüchtern JV, Sellenschloh K, Püschel K, Morlock MM, Rueger JM et al. Acromioclavicular joint dislocations: coracoclavicular reconstruction with and without additional direct acromioclavicular repair. KNEE SURG SPORT TR A. 2017 Jul;25(7):2025-2031. https://doi.org/10.1007/s00167-015-3920-1

Bibtex

@article{3b8948ef8412421aaa7cc444310d7eaa,
title = "Acromioclavicular joint dislocations: coracoclavicular reconstruction with and without additional direct acromioclavicular repair",
abstract = "PURPOSE: To evaluate different stabilisation techniques for acromioclavicular (AC) joint separations, including direct AC repair, and to compare the properties of the stabilised and native joints.METHODS: An established in vitro testing model for the AC joint was used to analyse joint stability after surgical reconstruction [double TightRope (DTR), DTR with AC repair (DTR + AC), single TR with AC repair (TR + AC), and PDS sling with AC repair (PDS + AC)]. Twenty-four human cadaveric shoulders were randomised by age into four testing groups. Joint stiffness was measured by applying an axial load during defined physiological ranges of motion. Similar tests were performed for the native joints, after dissecting the coracoclavicular and AC ligaments, and after surgical reconstruction. Cyclic loading was performed for 1000 cycles with 20-70 N and vertical load to failure determined after cyclic testing.RESULTS: Axial stiffness for all TR groups was significantly higher than for the native joint (DTR 38.94 N/mm, p = 0.005; DTR + AC 37.79 N/mm, p = 0.015; TR + AC 45.61 N/mm, p < 0.001 vs. native 26.05 N/mm). The axial stiffness of the PDS + AC group was similar to that of the native joint group (21.4 N/mm, n.s.). AC repair did not significantly influence rotational stiffness. Load to failure was similar and >600 N in all groups (n.s.).CONCLUSION: Reconstruction of AC dislocations with one or two TRs leads to stable results with a higher stiffness than the native joints. For the PDS + AC group, axial stiffness was similar to the native situation, although there might be a risk of elongation. Direct AC repair showed no significantly increased stability in comparison with reconstructions without direct AC repair. Thus, a direct AC repair seems to be dispensable in clinical practice, while TRs or PDS cerclages appear to provide sufficiently stable results.",
author = "Lukas Weiser and N{\"u}chtern, {Jakob V} and Kay Sellenschloh and Klaus P{\"u}schel and Morlock, {Michael M} and Rueger, {Johannes M} and Michael Hoffmann and Wolfgang Lehmann and Gro{\ss}terlinden, {Lars G}",
year = "2017",
month = jul,
doi = "10.1007/s00167-015-3920-1",
language = "English",
volume = "25",
pages = "2025--2031",
journal = "KNEE SURG SPORT TR A",
issn = "0942-2056",
publisher = "Springer",
number = "7",

}

RIS

TY - JOUR

T1 - Acromioclavicular joint dislocations: coracoclavicular reconstruction with and without additional direct acromioclavicular repair

AU - Weiser, Lukas

AU - Nüchtern, Jakob V

AU - Sellenschloh, Kay

AU - Püschel, Klaus

AU - Morlock, Michael M

AU - Rueger, Johannes M

AU - Hoffmann, Michael

AU - Lehmann, Wolfgang

AU - Großterlinden, Lars G

PY - 2017/7

Y1 - 2017/7

N2 - PURPOSE: To evaluate different stabilisation techniques for acromioclavicular (AC) joint separations, including direct AC repair, and to compare the properties of the stabilised and native joints.METHODS: An established in vitro testing model for the AC joint was used to analyse joint stability after surgical reconstruction [double TightRope (DTR), DTR with AC repair (DTR + AC), single TR with AC repair (TR + AC), and PDS sling with AC repair (PDS + AC)]. Twenty-four human cadaveric shoulders were randomised by age into four testing groups. Joint stiffness was measured by applying an axial load during defined physiological ranges of motion. Similar tests were performed for the native joints, after dissecting the coracoclavicular and AC ligaments, and after surgical reconstruction. Cyclic loading was performed for 1000 cycles with 20-70 N and vertical load to failure determined after cyclic testing.RESULTS: Axial stiffness for all TR groups was significantly higher than for the native joint (DTR 38.94 N/mm, p = 0.005; DTR + AC 37.79 N/mm, p = 0.015; TR + AC 45.61 N/mm, p < 0.001 vs. native 26.05 N/mm). The axial stiffness of the PDS + AC group was similar to that of the native joint group (21.4 N/mm, n.s.). AC repair did not significantly influence rotational stiffness. Load to failure was similar and >600 N in all groups (n.s.).CONCLUSION: Reconstruction of AC dislocations with one or two TRs leads to stable results with a higher stiffness than the native joints. For the PDS + AC group, axial stiffness was similar to the native situation, although there might be a risk of elongation. Direct AC repair showed no significantly increased stability in comparison with reconstructions without direct AC repair. Thus, a direct AC repair seems to be dispensable in clinical practice, while TRs or PDS cerclages appear to provide sufficiently stable results.

AB - PURPOSE: To evaluate different stabilisation techniques for acromioclavicular (AC) joint separations, including direct AC repair, and to compare the properties of the stabilised and native joints.METHODS: An established in vitro testing model for the AC joint was used to analyse joint stability after surgical reconstruction [double TightRope (DTR), DTR with AC repair (DTR + AC), single TR with AC repair (TR + AC), and PDS sling with AC repair (PDS + AC)]. Twenty-four human cadaveric shoulders were randomised by age into four testing groups. Joint stiffness was measured by applying an axial load during defined physiological ranges of motion. Similar tests were performed for the native joints, after dissecting the coracoclavicular and AC ligaments, and after surgical reconstruction. Cyclic loading was performed for 1000 cycles with 20-70 N and vertical load to failure determined after cyclic testing.RESULTS: Axial stiffness for all TR groups was significantly higher than for the native joint (DTR 38.94 N/mm, p = 0.005; DTR + AC 37.79 N/mm, p = 0.015; TR + AC 45.61 N/mm, p < 0.001 vs. native 26.05 N/mm). The axial stiffness of the PDS + AC group was similar to that of the native joint group (21.4 N/mm, n.s.). AC repair did not significantly influence rotational stiffness. Load to failure was similar and >600 N in all groups (n.s.).CONCLUSION: Reconstruction of AC dislocations with one or two TRs leads to stable results with a higher stiffness than the native joints. For the PDS + AC group, axial stiffness was similar to the native situation, although there might be a risk of elongation. Direct AC repair showed no significantly increased stability in comparison with reconstructions without direct AC repair. Thus, a direct AC repair seems to be dispensable in clinical practice, while TRs or PDS cerclages appear to provide sufficiently stable results.

U2 - 10.1007/s00167-015-3920-1

DO - 10.1007/s00167-015-3920-1

M3 - SCORING: Journal article

C2 - 26685688

VL - 25

SP - 2025

EP - 2031

JO - KNEE SURG SPORT TR A

JF - KNEE SURG SPORT TR A

SN - 0942-2056

IS - 7

ER -