Acromioclavicular joint dislocation: A comparative biomechanical study of the palmaris-longus tendon graft reconstruction with other augmentative methods in cadaveric models
Guntur E Luis , Chee-Khuen Yong , Deepak A Singh , S Sengupta and David S.K. Choon
Journal of Orthopaedic Surgery and Research 2007, 2:22
The objective of this study is to compare the biomechanical properties of a novel palmaris-longus tendon reconstruction with those of the native AC+CC ligaments, the modified Weaver-Dunn reconstruction, the ACJ capsuloligamentous complex repair, screw and clavicle hook plate augmentation. Study Design: Controlled laboratory cadaveric study
Native ligaments were the strongest and stiffest when compared to other modes of reconstruction and augmentation except coracoclavicular screw, in both posterior-anterior and superior directions (p<0.005). WD.ACJ provided additional posterior-anterior (P=0. 039) but not superior(p=0.250) stability when compared to WD alone. WD+PLmt, in loads and stiffness at failure superiorly, was similar to WD+CP (p=0.066). WD+PLmt , in loads and stiffness at failure postero-anteriorly, was similar to WD+ACJ (p=0.084). Superiorly, WD+CP had similar strength as WD+BS (p=0.057), but it was less stiff (p<0.005). Conclusions and Clinical Relevance: Modified Weaver-Dunn procedure must always be supplemented with acromioclavicular capsuloligamentous repair to increase posterior-anterior stability. Palmaris-Longus tendon graft provides both additional superior and posterior-anterior stability when used for acromioclavicular capsuloligamentous reconstruction. It is a good alternative to clavicle hook plate in acromioclavicular dislocation.