Kinematic Evaluation of the Modified Weaver-Dunn Acromioclavicular Joint Reconstruction

Abstract

Background:

Few reconstructive methods to treat displaced acromioclavicular separations have been evaluated using kinematic data.

Hypothesis:

The modified Weaver-Dunn reconstruction restores intact acromioclavicular joint motion during passive scapular plane abduction.

Study Design:

Controlled laboratory study.

Methods:

Acromioclavicular joint motion was recorded during passive humeral elevation in 3 states: an intact shoulder, an “injured” state in which the acromioclavicular and coracoclavicular ligaments were transected, and finally in a reconstructed state using a modified Weaver-Dunn reconstruction. Measurements were taken with an electromagnetic motion analysis system attached to rigid pins placed in the clavicle, scapula, humerus, and sternum during passive scapular plane humeral elevation.

Results:

Total translatory motion of the acromioclavicular joint in the cut state was significantly greater than both the intact and reconstructed states in the medial/lateral (intact, 4.3 mm; cut, 7.9 mm; reconstructed, 2.6 mm), anterior/posterior (intact, 4.8 mm; cut, 6.1 mm; reconstructed, 4.9 mm), and superior/inferior (intact, 4.1 mm; cut, 8.0 mm; reconstructed, 4.8 mm) directions. The maximum and minimum positions of the reconstructed state were significantly more anterior and inferior than in the intact state. A significant increase in acromioclavicular axial rotation was also found between the intact and cut state.

Conclusion:

The modified Weaver-Dunn reconstruction was found to restore motion of the acromioclavicular joint to near-intact values, but created a more anterior and inferior position of the clavicle with respect to the acromion.

Clinical Relevance:

These kinematic data support the modified Weaver-Dunn reconstruction as a kinematically sound procedure to treat displaced acromioclavicular joint injuries.