Sex-Based Differences in Optimal Tunnel Placement for Acromioclavicular Joint Reconstruction

Area of Science:

• Orthopedic surgery
• Sports medicine
• Anatomy

Background:

• Acromioclavicular (AC) joint reconstruction outcomes are influenced by tunnel placement.
• Limited research exists on sex-based differences in optimal tunnel positioning for AC joint surgery.

Purpose of the Study:

• To investigate sex-based differences in ideal tunnel positioning for AC joint reconstruction using radiographic measurements.
• To determine if anatomic variations influence optimal tunnel placement between male and female patients.

Main Methods:

• Retrospective analysis of 200 male and 200 female clavicle radiographs.
• Radiographic measurements included length from lateral clavicle to lateral coracoid (LCLC), lateral clavicle to medial coracoid (LCMC), clavicle length (CL), and midcoracoid depth (MCCD).
• Statistical analysis using Student t-test and Pearson correlation, with variables (P < .1) included in multiple regression.

Main Results:

• Significant sex-based differences were observed in LCLC and LCMC, with men exhibiting greater lengths.
• Clavicle length and MCCD were significantly correlated with LCLC and LCMC in both sexes.
• Approximate trapezoid tunnel placement was 22.1 mm for women and 26.6 mm for men; conoid tunnel placement was 40 mm for women and 46.6 mm for men.

Conclusions:

• Significant sex-based differences exist in coracoid positioning relative to the lateral clavicle.
• Coracoid position is correlated with anatomic parameters, particularly clavicle length, highlighting the need for sex-specific tunnel placement considerations in AC joint reconstruction.