Original articleMechanical properties of regenerated coracoacromial ligament after subacromial decompression☆
Section snippets
Materials and methods
During a series of primary open acromioplasty procedures, 7 CALs were excised for mechanical testing as controls. There were 2 female and 5 male patients in this group with a mean age of 59 years (range, 48-66 years). Four of these specimens included part of the acromial bone, whereas the other three had no bone attached to the CAL. Specimens from this group will be referred to as primary ligaments. Eight patients underwent revision surgery with open rotator cuff repair for persistent shoulder
Results
The measured mechanical properties for the primary CALs are shown in Table I. For comparison purposes, the properties of CALs in cadaveric shoulders with rotator cuff tears reported in a previous study11 have been included in Table I. Values determined in the current study are reasonably similar to those reported by Soslowsky et al,11 although the mechanical properties of the primary ligaments in our study tend to be somewhat lower than their reported values. This trend is expected, if we
Discussion
It appears that the CAL does have the ability to re-form relatively quickly after decompression, but it does not regain its normal strength and elasticity for at least 2 or 3 years. A close-up view of the regenerated ligaments revealed a variation in the macroscopic appearance through the thickness of the ligament in several cases (Figure 10). The bursal side of these ligaments seemed in parts to consist of shiny white fibrous tissue. Hypothetically, this may represent emerging normal ligament
Acknowledgements
The authors would like to thank Dr Peter Reily and Mr Roger Emery for providing specimens for the study.
References (12)
- et al.
Re-formation of the coracoacromial ligament after open resection or arthroscopic release
J Shoulder Elbow Surg
(2000) - et al.
Regeneration of the coraco-acromial ligament after acromioplasty and arthroscopic subacromial decompression
J Shoulder Elbow Surg
(2001) - et al.
Anatomic variation of the coracoacromial ligamenta macroscopic and microscopic cadaveric study
J Shoulder Elbow Surg
(1997) - et al.
Prosthetic replacement in rotator cuff-deficient shoulders
J Shoulder Elbow Surg
(1992) - et al.
Cross-sectional area measurement of soft tissue. A new casting method
J Biomechanics
(1996) - et al.
Design and evaluation of a cryogenic soft tissue fixation device—load tolerances and thermal aspects
J Biomechanics
(2001)
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