Hide All

2008 Publications

Cyclical loading of coracoclavicular ligament reconstructions: a comparative biomechanical studyby Lee SJ, Keefer EP, McHugh MP, Kremenic IJ, Orishimo KF, Ben-Avi S, Nicholas SJ. - last modified 2012-11-19 00:00
Am J Sports Med. 2008 Oct;36(10):1990-7.


BACKGROUND: Reconstruction for injuries to the acromioclavicular joint remains controversial.

HYPOTHESIS: A coracoclavicular ligament reconstruction with a semitendinosus tendon would have superior performance to the classic coracoacromial ligament transfer with or without augmentation.

STUDY DESIGN: Controlled laboratory study.

METHODS: Five cadaveric shoulders were used to reconstruct the coracoclavicular ligaments with 3 methods: coracoacromial ligament transfer without augmentation, coracoacromial ligament transfer augmented with No. 5 Ethibond suture, and a semitendinosus tendon. Each reconstruction was cyclically loaded at 40 N to 80 N for 2500 cycles, then from 40 N to 210 N for 2500 cycles, followed by loading to failure. The number of cycles to 50% and 100% loss of acromioclavicular joint reduction were recorded

RESULTS: During the 40 N to 80 N-loading cycle, the coracoacromial transfer without augmentation failed (15 +/- 16 cycles). The augmented coracoacromial ligament transfer and the semitendinosus reconstruction did not fail (P = .008). During the 40 N to 210 N-loading cycle, the augmented coracoacromial ligament transfer failed (207 +/- 399 cycles). The semitendinosus reconstruction survived through both loading cycles (P < .01).

CONCLUSION: Coracoclavicular ligament reconstruction with a semitendinosus graft is a biomechanically superior construct in a cyclically loaded setting to a coracoacromial ligament transfer augmented with a No. 5 Ethibond suture.

CLINICAL RELEVANCE: The semitendinosus graft is a strong, biologic option for reconstruction of the coracoclavicular ligaments.