| Cyclical loading of coracoclavicular ligament reconstructions: a comparative biomechanical study. | |
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MedLine Citation:
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PMID: 18832487 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Steven J Lee; Eric P Keefer; Malachy P McHugh; Ian J Kremenic; Karl F Orishimo; Simon Ben-Avi; Stephen J Nicholas |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: The American journal of sports medicine Volume: 36 ISSN: 1552-3365 ISO Abbreviation: Am J Sports Med Publication Date: 2008 Oct |
Date Detail:
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Created Date: 2008-10-03 Completed Date: 2009-01-21 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7609541 Medline TA: Am J Sports Med Country: United States |
Other Details:
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Languages: eng Pagination: 1990-7 Citation Subset: IM |
Affiliation:
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Nicholas Institute of Sports Medicine and Athletic Trauma, Lenox Hill Hospital, New York, NY 10075, USA. sjleemd@aol.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acromioclavicular Joint
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physiology,
surgery* Adult Biomechanics Cadaver Female Humans Ligaments, Articular / physiology, surgery* Male Middle Aged Tendon Transfer Tendons / physiology, transplantation Weight-Bearing |
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