Alaee Farhang, Apostolakos John, Singh Hardeep, Holwein Christian, Diermeier Theresa, Cote Mark P, Beitzel Knut, Imhoff Andreas B, Mazzocca Augustus D, Voss Andreas
Department of Orthopaedic Surgery, New England Musculoskeletal Institute, University of Connecticut, Farmington, CT, 06034, USA.
Department of Orthopaedic Sports Medicine, Technical University, Munich, Germany.
Knee Surg Sports Traumatol Arthrosc. 2017 Jul;25(7):2013-2019. doi: 10.1007/s00167-017-4444-7. Epub 2017 Feb 14.
To investigate the biomechanical performance of four different methods used for coracoclavicular (CC) ligament reconstruction in a lateral clavicle fracture repair.
Native displacement, translation, and rotation at the acromioclavicular joint of 24 fresh-frozen cadaveric shoulders were tested. A reproducible fracture in the lateral third of the clavicle was created by dissecting both CC ligaments. Each specimen was then repaired with plate fixation of the fracture and the following CC repair technique: (1) Cortical button. (2) Suture anchor and plate button. (3) Suture anchor no plate button, and (4) Suture around coracoid. All reconstructed specimens were then re-tested for displacement, translation, and load to failure, and compared to their native results. Groups 1 and 3 were investigated for rotational load.
There was no difference in load to failure between the repaired groups (p: ns). Group 1 showed less superior and anterior translations (p < 0.05). Group 2 showed significantly less superior translation (p = 0.003), but no significance with anterior and posterior translations to the native joint. Group 3 showed less superior and posterior translations (p = 0.005 and p = 0.039). Anterior and posterior translations were increased in group 4 (p < 0.05).
The biomechanical analyses did not show any significance in load to failure or displacement after cyclic loading among the study groups. All repairs were effective in preventing superior translation. Groups 1 and 2 demonstrated increased horizontal stability compared to the native state. All 4 methods are clinically viable options for CC ligament repair.
研究在锁骨外侧骨折修复中用于喙锁（CC）韧带重建的四种不同方法的生物力学性能。
测试了24个新鲜冷冻尸体肩部肩锁关节处的原位位移、平移和旋转情况。通过解剖两条CC韧带在锁骨外侧三分之一处制造出可重复的骨折。然后用骨折钢板固定和以下CC修复技术修复每个标本：（1）皮质纽扣。（2）缝线锚钉和钢板纽扣。（3）缝线锚钉无钢板纽扣，以及（4）喙突周围缝合。然后对所有重建标本重新进行位移、平移和破坏载荷测试，并与原位结果进行比较。对第1组和第3组进行旋转载荷研究。
修复组之间的破坏载荷没有差异（p：无统计学意义）。第1组显示出较少的向上和向前平移（p < 0.05）。第2组显示出明显较少的向上平移（p = 0.003），但与原位关节的前后平移无显著差异。第3组显示出较少的向上和向后平移（p = 0.005和p = 0.039）。第4组的前后平移增加（p < 0.05）。
生物力学分析显示，研究组在循环加载后的破坏载荷或位移方面没有任何显著差异。所有修复在防止向上平移方面都是有效的。与原位状态相比，第1组和第2组显示出增加的水平稳定性。所有4种方法都是CC韧带修复的临床可行选择。
