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The Biomechanical Efficacy of Tape Cerclage as an Augment or Standalone for Coracoclavicular Ligament Reconstruction

The Biomechanical Efficacy of Tape Cerclage as an Augment or Standalone for Coracoclavicular Ligament Reconstruction

Ian James Wellington, MD, UNITED STATES Benjamin C Hawthorne, BS, UNITED STATES Brian Ford, MD, UNITED STATES Caitlin G Dorsey, BS, UNITED STATES Kevin Quindlen, MS, UNITED STATES Bennett Propp, BS, UNITED STATES ELIFHO OBOPILWE, ME, BSc, UNITED STATES Paul J. Cagle, MD, UNITED STATES Augustus D. Mazzocca, MS, MD, UNITED STATES

University of Connecticut, Farmington, CT, UNITED STATES


2023 Congress   ePoster Presentation   2023 Congress   Not yet rated

 

Anatomic Location

Diagnosis / Condition


Summary: Tape cerclage augmentation may provide a useful augment for CC ligament reconstruction.


Background

Loss of initial reduction of the acromioclavicular (AC) joint following coracoclavicular (CC) ligament reconstruction remains a challenge for various repair techniques. Previous studies using polydioxanone suture cerclage augments for CC ligament reconstruction demonstrated poor clinical and biomechanical outcomes. Tape style sutures have recently gained popularity due to their added stiffness and strength relative to traditional sutures. These tape cerclage systems have yet to be biomechanically studied in CC ligament reconstruction.

Purpose

To determine the efficacy of a tape cerclage system as an augment to CC ligament reconstruction.
Study Design: Controlled laboratory study

Methods

Twenty-four human cadaveric shoulders were utilized. These were divided into four repair groups: anatomic coracoclavicular ligament reconstruction (ACCR), ACCR with a tape cerclage augment (ACCR + C), tendon graft sling with a cerclage augment (TGS + C), or tape cerclage alone (CS). The repairs underwent superior/inferior cyclic loading to evaluate for displacement. Specimens were visually inspected for cortical erosion by the tape cerclage following cyclic loading. Finally, the constructs underwent superior plane load to failure testing.

Results

Less displacement after cyclic loading was observed in the ACCR + C (.42mm ± .32), TGS + C (.92mm ± .42), and CS groups (.93mm ± .39) compared to the ACCR group (4.42mm ± 3.40; p=.002). ACCR + C (813.3N ± 257.5), TGS + C (558.0N ± 120.7), and CS (759.5N ± 173.7) demonstrated significantly greater load at failure relative to the ACCR group (329.2N ± 118.2; p<.001). The ACCR + C (60.88N/mm ± 17.3), TGS + C (44.97N/mm ± 9.15), and CS (54.52N/mm ± 14.24) conferred greater stiffness than the ACCR group (27.43N/mm ± 6.94; p = .001). No cortical erosion was demonstrated in any specimen after cyclic loading.

Conclusion

Repairs utilizing a tape cerclage system confer significantly greater load to failure and stiffness, as well as decreased displacement with cyclic loading, when compared to traditional ACCR repair.


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