Format

Send to

Choose Destination
Am J Sports Med. 2007 Jun;35(6):955-61. Epub 2007 Feb 22.

Biomechanical evaluation of minimally invasive repairs for complete acromioclavicular joint dislocation.

Author information

1
Department of Traumatology, Hand, and Reconstructive Surgery, University Hospital Muenster, Waldeyerstr. 1, 48149 Muenster, Germany. Mathias.Wellmann@ukmuenster.de

Abstract

BACKGROUND:

The conventional coracoclavicular ligament augmentation with a single polydioxanone loop has been shown to have some pivotal disadvantages.

HYPOTHESIS:

A minimally invasive flip button/polydioxanone repair provides similar biomechanical properties to the conventional polydioxanone cerclage around the coracoid. However, the authors expected a difference in linear stiffness, ultimate load, and permanent elongation between suture anchor repairs and polydioxanone repairs.

STUDY DESIGN:

Controlled laboratory study.

METHODS:

The tensile fixation strength of 4 different minimally invasive repairs was tested in a porcine metatarsal model: (1) 1.3-mm single polydioxanone cerclage with a subcoracoidal flip button fixation, (2) 1.3-mm single polydioxanone cerclage, (3) Twinfix Ti 3.5-mm/Ultrabraid 2-suture anchor, and (4) Twinfix Ti 5.0-mm/Ultrabraid 2-suture anchor. The testing protocol included cyclic superoinferior loading and a subsequent load to failure trial.

RESULTS:

The flip button repair (646 N) and the conventional polydioxanone banding (663 N) revealed significant higher ultimate loads than did the suture anchor repairs (295 and 331 N, respectively; P < .001), whereas no significant differences were found for the elongation behavior under cyclic loading.

CONCLUSION:

There was no significant difference between the 2 polydioxanone repairs. The ultimate load of the flip button procedure reaches the level of the native coracoclavicular ligament complex as it has been quantified in the literature.

CLINICAL RELEVANCE:

Although the biomechanical results comparing a minimally invasive flip button procedure versus a conventional polydioxanone cerclage are similar, the authors recommend the flip button procedure because of its minimally invasive approach and the secure subcoracoidal fixation technique with a minimized risk of anterior loop dislocation and neurovascular damage.

PMID:
17322128
DOI:
10.1177/0363546506298585
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Atypon
Loading ...
Support Center