Evaluation of the Clavicular Tunnel Placement on Coracoclavicular Ligament Reconstruction for Acromioclavicular Dislocations: a Finite Element Analysis

Overview

Journal Int Orthop

Specialty Orthopedics

Date 2018 Jan 29

PMID 29374781

Citations 2

Authors

Onur Kocadal

Korcan Yuksel

Melih Guven

Affiliations

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Abstract

Purpose: The two-tunnel coracoclavicular ligament reconstruction (CLR) technique is one of the treatment approaches commonly used in the surgical treatment of acromioclavicular (AC) injuries. Clavicular tunnel malposition is one of the major causes of failure in coracoclavicular ligament reconstruction. The main purpose of this study was to investigate the effects of clavicular tunnel placement on tendon loading in the CLR technique with finite element analysis.

Methods: Models of clavicle and scapula were constructed using computerized tomography images. Two clavicular bone tunnel reconstruction models were created with the tendon passing through the conoid and trapezoid tunnels. Four models based on the tunnel ratio (TR) method and defined as primary, anatomic, medialized, and lateralized were constructed to evaluate the effect of tunnel placement on loading conditions during tendon graft. All models were loaded by insertion from the trapezius and sternocleidomastoid muscles. The loading on the tendon were evaluated with the finite element analysis.

Results: The highest load value measured on the tendon was in the anatomic model (0.789 kPa), and the lowest load value (0.598 kPa) was measured in the lateralized tunnel model. The load value of the primary model was (0.657 kPa), and the medialized model's value was (0.752 kPa).

Conclusions: In two-tunnel CLR technique, tendon loadings are related to tunnel placement. Medialized tunnel placement increases tendon loading. The TR method may be an appropriate option for determining tunnel placement.

Citing Articles

[Application of TightRope system combined with Locking-Loop biplane anatomical reconstruction technique for acute acromioclavicular joint dislocation].

Xu J, Kang Y, Bi W, Ji Y, Ma W, Yang D Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2023; 37(3):257-263.

PMID: 36940981 PMC: 10027527. DOI: 10.7507/1002-1892.202212069.

Evaluation of the coracoid bone tunnel placement on Dog Bone™ button fixation for acromioclavicular joint dislocation: a cadaver study combined with finite element analysis.

Gao R, Zhang W, Yang Y, Zhang Y, Hu Y, Wu H BMC Musculoskelet Disord. 2023; 24(1):18.

PMID: 36624428 PMC: 9827623. DOI: 10.1186/s12891-022-06119-6.

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