Union Memorial Orthopaedics, 3333 North Calvert Street, Baltimore, MD 21218, USA.
Am J Sports Med. 2010 Jun;38(6):1204-8. doi: 10.1177/0363546509359064. Epub 2010 Apr 14.
The standard Weaver-Dunn reconstruction of the acromioclavicular (AC) joint does not provide adequate superoinferior or anteroposterior stability. Augmentation methods such as tape cerclage have been described. A new method of augmentation with the Arthrex TightRope is available.
A Weaver-Dunn reconstruction augmented with the TightRope will provide superior superoinferior and anteroposterior stability to the AC joint as compared with a Weaver-Dunn reconstruction augmented with Mersilene fiber tape cerclage.
Controlled laboratory study.
Six matched pairs of cadaveric shoulders underwent Weaver-Dunn AC joint reconstructions and were randomly assigned to receive either the TightRope device or tape cerclage augmentation. Translation in 2 planes was measured in the intact state under load and after 1 load cycle and 2000 load cycles.
TightRope-augmented repair showed less superoinferior translation (mean +/- standard error) than cerclage-augmented repair in initially repaired (1.6 +/- 0.1 mm vs 5.0 +/- 1.1 mm, P = 0.03) and cyclically loaded (2.1 +/- 0.1 mm vs 5.8 +/- 1.2 mm, P = 0.02) conditions. TightRope repairs were stiffer than the native ligaments in the superoinferior plane. Less anteroposterior translation was observed with TightRope versus cerclage augmentation (initially repaired, 6.8 +/- 0.4 mm vs 18.8 +/- 2.6 mm, P < 0.001; cycled, 15.0 +/- 1.4 mm vs 28.3 +/- 2.7 mm, P = 0.01), but neither method maintained normal anteroposterior laxity after 1500 cycles compared with the intact state.
Superoinferior and anteroposterior translation with TightRope augmentation was lower than with tape cerclage.
TightRope augmentation of a Weaver-Dunn procedure could provide increased protection for AC joint reconstruction, allowing for earlier mobilization and more aggressive early rehabilitation. The potential clinical effect of additional tightening in the superoinferior direction beyond that of the native joint remains an issue for further study.
肩锁关节（AC）的标准 Weaver-Dunn 重建不能提供足够的上下或前后稳定性。已经描述了诸如带环扎的增强方法。现在有了一种新的 Arthrex TightRope 增强方法。
与 Weaver-Dunn 重建中使用 Mersilene 纤维带环扎增强相比，TightRope 增强的 Weaver-Dunn 重建将为 AC 关节提供更好的上下和前后稳定性。
对照实验室研究。
6 对匹配的尸体肩部进行了 Weaver-Dunn AC 关节重建，并随机分配接受 TightRope 装置或带环扎增强。在负荷下和 1 个负荷循环和 2000 个负荷循环后测量 2 个平面的平移。
在初始修复（1.6 +/- 0.1 毫米比 5.0 +/- 1.1 毫米，P = 0.03）和循环加载（2.1 +/- 0.1 毫米比 5.8 +/- 1.2 毫米，P = 0.02）条件下，TightRope 增强修复的上下位移小于带环扎增强修复。TightRope 修复在上下平面比天然韧带更僵硬。与带环扎增强相比，TightRope 修复的前后位移更小（初始修复，6.8 +/- 0.4 毫米比 18.8 +/- 2.6 毫米，P < 0.001；循环，15.0 +/- 1.4 毫米比 28.3 +/- 2.7 毫米，P = 0.01），但与完整状态相比，两种方法在 1500 次循环后都无法保持正常的前后松弛度。
与带环扎增强相比，TightRope 增强的上下和前后位移更低。
Weaver-Dunn 手术中 TightRope 增强可提供对 AC 关节重建的更多保护，允许更早地活动和更积极的早期康复。在上下方向上增加的紧固效果超过了天然关节，这仍然是一个需要进一步研究的问题。
Zotero 插件