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Reconstruction of the coracoclavicular ligaments with tendon grafts: a comparative biomechanical study
by
Lee SJ, Nicholas SJ, Akizuki KH, McHugh MP, Kremenic IJ, Ben-Avi S.
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last modified
2009-10-09 15:16
Am J Sports Med. 2003 Sep-Oct;31(5):648-55.
BACKGROUND: Numerous surgical techniques have been described to address injuries
to the coracoclavicular ligaments. PURPOSE: To compare the biomechanical
properties of tendon graft reconstructions with those of the native
coracoclavicular ligaments and various other repair methods. STUDY DESIGN:
Controlled laboratory study. METHODS: Eleven fresh-frozen human cadaveric
shoulders were tensile tested to failure to compare the biomechanical properties
of the native coracoclavicular ligaments, coracoacromial ligament transfer, No. 5
Mersilene suture repair, 5-mm Mersilene tape repair, and tendon graft
reconstructions with gracilis, semitendinosus, and long toe extensor tendons.
RESULTS: Reconstructions with semitendinosus, gracilis, or long toe extensor
tendon grafts were found to have superior initial biomechanical properties
compared with coracoacromial ligament transfer; failure strengths were as strong
as those of the native coracoclavicular ligaments. Failure of the tendon grafts
occurred through the midsubstance of the tendon graft, not at the fixation site.
CONCLUSIONS: Tendon graft reconstruction may be an alternative to coracoacromial
ligament transfer and may provide a permanent biologic reconstruction with
superior initial biomechanical properties, including that of tensile strength.
CLINICAL RELEVANCE: Use of tendon graft reconstruction may limit the need for
postoperative immobilization and lead to an accelerated rehabilitation program.