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Updated: May 27, 2026
Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
Biomechanical evaluation of a novel reverse coracoacromial ligament reconstruction for acromioclavicular joint
Beatrice Shu1, Tyler Johnston, Derek P Lindsey
1Department of Orthopaedic Surgery, Stanford University, CA, USA.
Background:
Enhancing anterior-posterior (AP) stability in acromioclavicular (AC) reconstruction may be advantageous.
Purpose:
To compare the initial stability of AC reconstructions with and without augmentation by either (1) a novel "reverse" coracoacromial (CA) ligament transfer or (2) an intramedullary AC tendon graft.
Hypothesis:
Reverse CA transfer will improve AP stability compared with isolated coracoclavicular (CC) reconstruction.
Study Design:
Controlled laboratory study.
Methods:
Six matched pairs of cadaveric shoulders underwent distal clavicle resection and CC reconstruction. Displacement (mm) was measured during cyclic loading along AP (±25 N) and superior-inferior (SI; 10-N compression, 70-N tension) axes. Pairs were randomized to receive each augmentation and the same loading protocol applied.
Results:
Reverse CA transfer (3.71 ± 1.3 mm, standard error of the mean [SEM]; P = .03) and intramedullary graft (3.41 ± 1.1 mm; P = .03) decreased AP translation compared with CC reconstruction alone. The SI displacement did not differ. Equivalence tests suggest no difference between augmentations in AP or SI restraint.
Conclusion:
Addition of either reverse CA transfer or intramedullary graft demonstrates improved AP restraint and provides similar SI stability compared with isolated CC reconstruction.
Clinical Relevance:
Reverse CA ligament transfer may be a reasonable alternative to a free tendon graft to augment AP restraint in AC reconstruction.