The reverse coracoacromial ligament transfer for "horizontal" acromioclavicular joint instability

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Anatomy

Background:

• Acromioclavicular (AC) joint horizontal instability affects athletes and older patients post-surgery.
• This instability can lead to pain and functional deficits if not addressed during reconstruction.
• Reconstruction must consider horizontal clavicle instability alongside superior instability.

Purpose of the Study:

• To investigate the extent of horizontal clavicle instability following distal clavicle resection.
• To evaluate the effectiveness of a reverse coracoacromial ligament transfer technique in restoring horizontal stability.

Main Methods:

• Cadaveric dissection of the AC joint capsule and its attachments.
• Simulated distal clavicle resection and measurement of horizontal clavicular displacement under load.
• Application and assessment of a reverse coracoacromial ligament reconstruction technique.

Main Results:

• Horizontal clavicular translation significantly increased with increasing distal clavicle resection.
• Significant horizontal instability was observed with resections exceeding 10 mm.
• The reverse coracoacromial ligament transfer demonstrated potential for restoring horizontal stability.

Conclusions:

• Distal clavicle resection greater than 10 mm leads to evident horizontal clavicle instability.
• Reverse coracoacromial ligament transfer is a viable option for addressing horizontal stability in AC joint reconstruction for painful instability.