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International Orthopaedics

, Volume 42, Issue 8, pp 1891–1896 | Cite as

Evaluation of the clavicular tunnel placement on coracoclavicular ligament reconstruction for acromioclavicular dislocations: a finite element analysis

  • Onur Kocadal
  • Korcan Yüksel
  • Melih Güven
Original Paper
  • 115 Downloads

Abstract

Purpose

The two-tunnel coracoclavicular ligament reconstruction (CLR) technique is one of the treatment approaches commonly used in the surgical treatment of acromioclavicular (AC) injuries. Clavicular tunnel malposition is one of the major causes of failure in coracoclavicular ligament reconstruction. The main purpose of this study was to investigate the effects of clavicular tunnel placement on tendon loading in the CLR technique with finite element analysis.

Methods

Models of clavicle and scapula were constructed using computerized tomography images. Two clavicular bone tunnel reconstruction models were created with the tendon passing through the conoid and trapezoid tunnels. Four models based on the tunnel ratio (TR) method and defined as primary, anatomic, medialized, and lateralized were constructed to evaluate the effect of tunnel placement on loading conditions during tendon graft. All models were loaded by insertion from the trapezius and sternocleidomastoid muscles. The loading on the tendon were evaluated with the finite element analysis.

Results

The highest load value measured on the tendon was in the anatomic model (0.789 kPa), and the lowest load value (0.598 kPa) was measured in the lateralized tunnel model. The load value of the primary model was (0.657 kPa), and the medialized model’s value was (0.752 kPa).

Conclusions

In two-tunnel CLR technique, tendon loadings are related to tunnel placement. Medialized tunnel placement increases tendon loading. The TR method may be an appropriate option for determining tunnel placement.

Keywords

Acromioclavicular dislocation Coracoclavicular reconstruction Tunnel placement Finite element analysis Conoid ligament Trapezoid ligament 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This manuscript does not contain any studies with animals or human participants performed by any of the authors.

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Copyright information

© SICOT aisbl 2018

Authors and Affiliations

  1. 1.Faculty of Medicine, Department of Orthopaedics and TraumatologyYeditepe UniversityIstanbulTurkey
  2. 2.Department of Orthopaedics and TraumatologyBayindir HospitalIstanbulTurkey

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