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Clavicular-Sided Tears Were the Most Frequent Mode of Failure During Biomechanical Analysis of Acromioclavicular Ligament Complex Failure During Adduction of the Scapula

PURPOSE: The purpose of this study was to describe the force and failure pattern of the acromioclavicular ligament complex (ACLC) in an adducted scapula, potentially simulating an indirect force injury of the AC joint. By using a biomechanical simulation in which the scapula is moved and the clavicl...

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Autores principales: DiCosmo, Michael B., Rumpf, Nathan, Mancini, Michael R., Obopilwe, Elifho, Arciero, Robert A., Mazzocca, Augustus D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8689223/
https://www.ncbi.nlm.nih.gov/pubmed/34977626
http://dx.doi.org/10.1016/j.asmr.2021.07.031
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author DiCosmo, Michael B.
Rumpf, Nathan
Mancini, Michael R.
Obopilwe, Elifho
Arciero, Robert A.
Mazzocca, Augustus D.
author_facet DiCosmo, Michael B.
Rumpf, Nathan
Mancini, Michael R.
Obopilwe, Elifho
Arciero, Robert A.
Mazzocca, Augustus D.
author_sort DiCosmo, Michael B.
collection PubMed
description PURPOSE: The purpose of this study was to describe the force and failure pattern of the acromioclavicular ligament complex (ACLC) in an adducted scapula, potentially simulating an indirect force injury of the AC joint. By using a biomechanical simulation in which the scapula is moved and the clavicle is fixed, we are able to better replicate the in vivo motion of the joint. METHODS: Ten cadaveric shoulders (mean age of 62.0 ± 8.6) with a bone mineral density of .51 ± .18 g/cm(2) were used. A standard reproducible anatomic mounting system was used to secure the clavicle and move the scapula. Displacement control was used to adduct the scapula (inferior angle of the scapula moving toward the clavicle) with the clavicle fixed until specimen failure, producing torque and angle of rotation. The failure mode of the ACLC during this simulated adduction was analyzed with slow motion video analysis. Tears of the ACLC were characterized as clavicular, midline, or acromion-sided tears. RESULTS: The mean torque required for load to failure was found to be 27.75 N-m (95% CI [20.85 N-m, 34.65 N-m]). The mean rotary angle at failure was 30° (95% CI [25°, 35°]). The mean stiffness (resistance provided by the ACLC) was 1.64 N-m/° (95% CI [1.28 N-m/°, 2.01 N-m/°]. Mode of failure analysis showed there were 6 clavicle-sided tears, 1 acromion-sided tear, 2 acromion fractures, and 1 clavicle fracture. CONCLUSIONS: Clavicular side tears were the most frequent mode of failure compared to midline and acromion side tears. The first segment of the ACLC to fail most frequently during adduction was the posterosuperior ligament. CLINICAL RELEVANCE: This biomechanical study simulates a potential mechanism of AC ligament injury. Additional knowledge about the mode of failure provides a better understanding of the ACLC, allowing for new information for the purpose of AC ligament reconstruction.
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spelling pubmed-86892232021-12-30 Clavicular-Sided Tears Were the Most Frequent Mode of Failure During Biomechanical Analysis of Acromioclavicular Ligament Complex Failure During Adduction of the Scapula DiCosmo, Michael B. Rumpf, Nathan Mancini, Michael R. Obopilwe, Elifho Arciero, Robert A. Mazzocca, Augustus D. Arthrosc Sports Med Rehabil Original Article PURPOSE: The purpose of this study was to describe the force and failure pattern of the acromioclavicular ligament complex (ACLC) in an adducted scapula, potentially simulating an indirect force injury of the AC joint. By using a biomechanical simulation in which the scapula is moved and the clavicle is fixed, we are able to better replicate the in vivo motion of the joint. METHODS: Ten cadaveric shoulders (mean age of 62.0 ± 8.6) with a bone mineral density of .51 ± .18 g/cm(2) were used. A standard reproducible anatomic mounting system was used to secure the clavicle and move the scapula. Displacement control was used to adduct the scapula (inferior angle of the scapula moving toward the clavicle) with the clavicle fixed until specimen failure, producing torque and angle of rotation. The failure mode of the ACLC during this simulated adduction was analyzed with slow motion video analysis. Tears of the ACLC were characterized as clavicular, midline, or acromion-sided tears. RESULTS: The mean torque required for load to failure was found to be 27.75 N-m (95% CI [20.85 N-m, 34.65 N-m]). The mean rotary angle at failure was 30° (95% CI [25°, 35°]). The mean stiffness (resistance provided by the ACLC) was 1.64 N-m/° (95% CI [1.28 N-m/°, 2.01 N-m/°]. Mode of failure analysis showed there were 6 clavicle-sided tears, 1 acromion-sided tear, 2 acromion fractures, and 1 clavicle fracture. CONCLUSIONS: Clavicular side tears were the most frequent mode of failure compared to midline and acromion side tears. The first segment of the ACLC to fail most frequently during adduction was the posterosuperior ligament. CLINICAL RELEVANCE: This biomechanical study simulates a potential mechanism of AC ligament injury. Additional knowledge about the mode of failure provides a better understanding of the ACLC, allowing for new information for the purpose of AC ligament reconstruction. Elsevier 2021-08-28 /pmc/articles/PMC8689223/ /pubmed/34977626 http://dx.doi.org/10.1016/j.asmr.2021.07.031 Text en © 2021 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Article
DiCosmo, Michael B.
Rumpf, Nathan
Mancini, Michael R.
Obopilwe, Elifho
Arciero, Robert A.
Mazzocca, Augustus D.
Clavicular-Sided Tears Were the Most Frequent Mode of Failure During Biomechanical Analysis of Acromioclavicular Ligament Complex Failure During Adduction of the Scapula
title Clavicular-Sided Tears Were the Most Frequent Mode of Failure During Biomechanical Analysis of Acromioclavicular Ligament Complex Failure During Adduction of the Scapula
title_full Clavicular-Sided Tears Were the Most Frequent Mode of Failure During Biomechanical Analysis of Acromioclavicular Ligament Complex Failure During Adduction of the Scapula
title_fullStr Clavicular-Sided Tears Were the Most Frequent Mode of Failure During Biomechanical Analysis of Acromioclavicular Ligament Complex Failure During Adduction of the Scapula
title_full_unstemmed Clavicular-Sided Tears Were the Most Frequent Mode of Failure During Biomechanical Analysis of Acromioclavicular Ligament Complex Failure During Adduction of the Scapula
title_short Clavicular-Sided Tears Were the Most Frequent Mode of Failure During Biomechanical Analysis of Acromioclavicular Ligament Complex Failure During Adduction of the Scapula
title_sort clavicular-sided tears were the most frequent mode of failure during biomechanical analysis of acromioclavicular ligament complex failure during adduction of the scapula
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8689223/
https://www.ncbi.nlm.nih.gov/pubmed/34977626
http://dx.doi.org/10.1016/j.asmr.2021.07.031
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