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Superior clavicle drilling points and fluoroscopic inclination for anatomic coracoclavicular ligament reconstruction: a cadaveric study

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

This study aims to investigate the superior clavicle cortex drilling points and fluoroscopic inclination angles for anatomic tunnel drilling in coracoclavicular ligament reconstruction.

Methods

Twelve cadaveric shoulders with a mean age of 55.9 ± 6.2 years were investigated. Two 2.0 mm Kirschner wires were inserted penetrating the footprint centers of conoid and trapezoid both on the clavicle and coracoid. The location of the Kirschner wires on the superior clavicle cortex was measured. Fluoroscopy was used to obtain three views of shoulder: an anteroposterior, lateral, and cortical ring sign view. Reproducible angles were then recorded.

Results

The Kirschner wire penetrating the conoid was located 40.0 ± 3.9 mm from the distal end and 18.1 ± 3.0 mm from the anterior edge of the clavicle. For the trapezoid, the Kirschner wire was located 19.1 ± 3.6 mm from the distal end and 9.9 ± 3.9 mm from the anterior edge. On the anteroposterior view, the conoid was 11.1° ± 10.1° medially and trapezoid was 26.8° ± 11.8° laterally tilted to the glenohumeral joint line. On the lateral view, the conoid was 42.8° ± 15.1° and trapezoid was 15.5° ± 12.0° superiorly tilted to the scapular spine. On the cortical ring sign view, the conoid was 50.8° ± 12.9° and trapezoid was 14.2 °± 11.0° superiorly tilted to the scapular spine.

Conclusions

The superior clavicle cortex drilling points and fluoroscopic inclination angles for anatomic tunnel drilling in coracoclavicular ligament reconstruction were demonstrated. Arthroscopy-assisted anatomic coracoclavicular ligament reconstruction has increased in popularity, and these findings may facilitate a more anatomic approach to coracoclavicular ligament reconstruction.

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Funding

No external funding was used.

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Authors and Affiliations

  1. Orthopaedic Robotics Laboratory, University of Pittsburgh, Pittsburgh, PA, USA

    Tetsuya Takenaga, Masahito Yoshida, Richard E. Debski, Freddie H. Fu, Volker Musahl & Albert Lin

  2. Department of Orthopaedic Surgery, University of Pittsburgh, UPMC Freddie Fu Sports Medicine Center, 3200 South Water Street, Pittsburgh, PA, 15203, USA

    Tetsuya Takenaga, Masahito Yoshida, Richard E. Debski, Freddie H. Fu, Volker Musahl & Albert Lin

  3. Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA

    Richard E. Debski, Freddie H. Fu & Volker Musahl

Authors
  1. Tetsuya Takenaga
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  2. Masahito Yoshida
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  3. Richard E. Debski
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  4. Freddie H. Fu
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  5. Volker Musahl
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  6. Albert Lin
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Correspondence to Albert Lin.

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The authors declare that they have no competing interests.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Takenaga, T., Yoshida, M., Debski, R.E. et al. Superior clavicle drilling points and fluoroscopic inclination for anatomic coracoclavicular ligament reconstruction: a cadaveric study. Knee Surg Sports Traumatol Arthrosc 27, 3813–3820 (2019). https://doi.org/10.1007/s00167-019-05539-7

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  • DOI: https://doi.org/10.1007/s00167-019-05539-7

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