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Treatment of acromioclavicular joint separation: Suture or suture anchors?

Authors: Breslow MJ, Jazrawi LM, Bernstein AD, Kummer FJ, Rokito AS

References: Journal of Shoulder and Elbow Surgery - May 2002 (Vol. 11, Issue 3, Pages 225-229)

Abstract
This investigation compared the stability of 2 methods of fixation for acromioclavicular (AC) joint separations. A complete AC joint separation was simulated in 6 matched pairs of fresh-frozen human cadaveric shoulders. One specimen from each pair was repaired with two No. 5 nonabsorbable braided sutures passed around the base of the coracoid and the other with 2 suture anchors preloaded with the same suture material placed into the base of the coracoid process. The specimens were cyclically loaded for 104 cycles to simulate our early postoperative rehabilitation protocol for coracoclavicular repairs. Before cycling, the repairs had a mean superior laxity of 1.68 ± 0.44 mm for the sutures alone and 1.23 ± 0.31 mm for the suture anchors. After 104 cycles, the laxity was 1.32 ± 0.59 mm and 1.33 ± 0.94 mm, respectively. These differences were not statistically significant (P = .2). This study demonstrated that similar stability can be achieved for coracoclavicular fixation with suture anchors or with sutures placed around the base of the coracoid for the treatment of AC joint separations. The clinical relevance includes the following: (1) the potentially diminished risk of neurovascular injury with the use of suture anchors compared with the passage of sutures around the base of the coracoid and (2) the potentially reduced surgical time associated with the use of suture anchors.

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