Hattori Fumiya, Ochiai Nobuyasu, Hashimoto Eiko, Shimada Yohei, Ise Shohei, Inagaki Kenta, Hiraoka Yu, Ohtori Seiji
Department of Orthopedic Surgery, Chiba University Hospital, Chiba, Japan.
Clin Shoulder Elb. 2025 Jul 2;28(3):274-80. doi: 10.5397/cise.2025.00157.
Acromioclavicular (AC) joint (ACJ) dislocation can lead to superior clavicular instability when the AC and coracoclavicular (CC) ligaments are torn. No previous study has assessed the effects of combined AC-CC ligament resections in fresh-frozen cadavers with preserved soft tissues around the thorax and shoulder girdle. This study aimed to develop such an ACJ dislocation model and evaluate stability following ligament resections.
Nine fresh-frozen cadaver shoulders (mean age, 86.6 years) without clavicular fractures or ACJ osteoarthritis were used. Each specimen included the thoracic spine, scapula, clavicle, and shoulder. Biomechanical testing was performed with a customized system to assess displacement and evaluate superior and posterior stability. Three conditions were compared: intact ligaments, AC ligament resection, and AC-CC ligament resection.
Superior translations were 0.0 mm (intact), 1.1 mm (AC resection), and 9.6 mm (AC-CC resection). Posterior translations were 0.0 mm, 3.2 mm, and 9.0 mm, respectively. The AC-CC resection group showed significantly increased translations compared to the intact and AC resection groups. No significant difference was observed between the intact and AC resection groups in superior translation. Posterior translation increased progressively from intact to AC and then AC-CC resection.
This is the first study to assess both superior and posterior ACJ stability using cadavers with preserved soft tissues. Our findings demonstrate the importance of the AC and CC ligaments in maintaining ACJ stability. Notably, the AC ligament contributes to posterior stability, indicating the need for reconstruction to achieve overall joint stability. Level of evidence: Controlled laboratory study.
当肩锁（AC）关节（ACJ）脱位且肩锁韧带和喙锁（CC）韧带撕裂时，可导致锁骨上方不稳定。此前尚无研究评估在保留胸部和肩胛带周围软组织的新鲜冷冻尸体上联合切除AC-CC韧带的效果。本研究旨在建立这样一种ACJ脱位模型，并评估韧带切除后的稳定性。
使用9个无锁骨骨折或ACJ骨关节炎的新鲜冷冻尸体肩部（平均年龄86.6岁）。每个标本包括胸椎、肩胛骨、锁骨和肩部。使用定制系统进行生物力学测试，以评估位移并评估上方和后方稳定性。比较了三种情况：韧带完整、AC韧带切除和AC-CC韧带切除。
上方移位分别为0.（韧带完整）、1.1（AC韧带切除）和9.6（AC-CC韧带切除）。后方移位分别为0.0、3.2和9.0。与韧带完整组和AC韧带切除组相比，AC-CC切除组的移位明显增加。韧带完整组和AC韧带切除组在上方移位方面未观察到显著差异。后方移位从韧带完整到AC韧带切除再到AC-CC切除逐渐增加。
这是第一项使用保留软组织的尸体评估ACJ上方和后方稳定性的研究。我们的研究结果表明了AC和CC韧带在维持ACJ稳定性中的重要性。值得注意的是，AC韧带有助于后方稳定性，这表明需要进行重建以实现整体关节稳定性。证据水平：对照实验室研究。
