The Role of the Acromioclavicular Ligament in Acromioclavicular Joint Stability: A Cadaveric Biomechanical Study.

• Material Type: 博士論文
• Title: The Role of the Acromioclavicular Ligament in Acromioclavicular Joint Stability: A Cadaveric Biomechanical Study.
• Author/Editor: Kurata, Shimpei; Inoue, Kazuya; Hasegawa, Hideo; Shimizu, Takamasa; Iida, Akio; Kawamura, Kenji; Omokawa, Shohei; Mahakkanukrauh, Pasuk; Tanaka, Yasuhito
• Author Heading: Kurata, Shimpei; Inoue, Kazuya; Hasegawa, Hideo; Shimizu, Takamasa; Iida, Akio; Kawamura, Kenji; Omokawa, Shohei; Mahakkanukrauh, Pasuk; Tanaka, Yasuhito
• Publication, Distribution, etc.: SAGE Publishing
• Publication Date: 2021-02-10
• Publication Date (W3CDTF): 2021-02-10
• Alternative Title: 肩鎖関節の安定性における肩鎖靭帯の役割 : 新鮮凍結屍体を用いた生体力学的研究
• Periodical title: Orthopaedic journal of sports medicine
• No. or year of volume/issue: 9 2
• Volume: 9
• Issue: 2
• Pages: Article No.2325967120982947-
• ISSN (Periodical Title): ISSN : 2325-9671
• Degree grantor/type: 奈良県立医科大学
• Date Granted: 2022-03-15
• Dissertation Number: 甲第810号
• Degree Type: 博士（医学）
• Text Language Code: eng
• Subject Heading: biomechanical study; fresh-frozen cadaveric study; acromioclavicular joint dislocation; acromioclavicular ligament; Rockwood classification
• Target Audience: 一般
• Note (General): type:Thesis; Background: Acromioclavicular (AC) joint dislocation is evaluated using the radiologically based Rockwood classification. The relationship between ligamentous injury and radiological assessment is still controversial. Purpose/hypothesis: To investigate how the AC ligament and trapezoid ligament biomechanically contribute to the stability of the AC joint using cadaveric specimens. The hypothesis was that isolated sectioning of the AC ligament would result in increased instability in the superior direction and that displacement >50% of the AC joint would occur. Study design: Controlled laboratory study. Methods: Six shoulders from 6 fresh-frozen cadavers were used in this study. Both the scapula and sternum were solidly fixed on a customized wooden jig with an external fixator. We simulated distal clavicular dislocation with sequential sectioning of the AC and coracoclavicular (CC) ligaments. Sectioning stages were defined as follows: stage 0, the AC ligament, CC ligament, and AC joint capsule were left intact; stage 1, the anteroinferior bundle of the AC ligament, joint capsule, and disk were sectioned; stage 2, the superoposterior bundle of the AC ligament was sectioned; and stage 3, the trapezoid ligament was sectioned. The distal clavicle was loaded with 70 N in the superior and posterior directions, and the magnitudes of displacement were measured. Results: The amounts of superior displacement averaged 3.7 mm (stage 0), 3.8 mm (stage 1), 8.3 mm (stage 2), and 9.5 mm (stage 3). Superior displacement >50% of the AC joint was observed in stage 2 (4/6; 67%) and stage 3 (6/6; 100%). The magnitudes of posterior displacement were 3.7 mm (stage 0), 3.7 mm (stage 1), 5.6 mm (stage 2), and 9.8 mm (stage 3). Posterior displacement >50% of the AC joint was observed in stage 3 (1/6; 17%). Conclusion: We found that the AC ligaments contribute significantly to AC joint stability, and superior displacement >50% of the AC joint can occur with AC ligament tears alone. Clinical relevance: The AC ligament plays an important role not only in horizontal stability but also in vertical stability of the AC joint.; 博士（医学）・甲第810号・令和4年3月15日; © The Author(s) 2021. This open-access article is published and distributed under the Creative Commons Attribution - NonCommercial - No Derivatives License (https://creativecommons.org/ licenses/by-nc-nd/4.0/), which permits the noncommercial use, distribution, and reproduction of the article in any medium, provided the original author and source are credited. You may not alter, transform, or build upon this article without the permission of the Author(s). For article reuse guidelines, please visit SAGE’s website at http://www.sagepub.com/journals-permissions.; identifier:Orthopaedic journal of sports medicine Vol.9 No.2 Article No.2325967120982947 (2021 Feb); identifier:23259671; identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3993; identifier:Orthopaedic journal of sports medicine, 9(2): Article No.2325967120982947
• Access Restrictions: インターネット公開
• Related Material (DOI): 10.1177/2325967120982947
• Data Provider (Database): 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• Original Data Provider (Database): 奈良県立医科大学 : 奈良県立医科大学機関リポジトリ GINMU

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