Which stabilization technique corrects anatomy best in patients with AC-separation? An experimental study

Area of Science:

• Orthopedic Surgery
• Anatomy

Background:

• Acromioclavicular (AC) joint injuries often require surgical reconstruction.
• Evaluating the anatomical accuracy of different AC reconstruction techniques is crucial for optimal patient outcomes.

Purpose of the Study:

• To compare the anatomical accuracy of eight different acromioclavicular reconstruction techniques.
• To identify the technique that best restores native shoulder joint parameters.

Main Methods:

• Ten human cadaveric shoulder specimens were used.
• Measurements of vertical, horizontal, and mediolateral acromioclavicular distance, and clavicular rotation were taken before and after AC reconstruction.
• Eight distinct surgical techniques were assessed.

Main Results:

• Vertical acromioclavicular distance was well reconstructed by most techniques.
• Several techniques, particularly the coracoid-sling procedure, caused significant anterior clavicular displacement.
• Conventional methods often resulted in acromial lateralization and clavicular rotation.
• A bone anchor system with distal coracoid fixation and a medialized clavicular hole demonstrated superior anatomical restoration.

Conclusions:

• Most AC reconstruction techniques do not fully restore native shoulder anatomy.
• A novel bone anchor technique provides the most accurate anatomical reconstruction of the acromioclavicular joint.