Biomechanical Rationale for Development of Anatomical Reconstructions of Coracoclavicular Ligaments After Complete Acromioclavicular Joint Dislocations

Background: Surgical treatments of complete acromioclavicular joint dislocations replace or reconstruct the coracoclavicular ligaments with a single structure and do not account for the anatomical variance of each ligament in the design. Purpose: To evaluate the cyclic behavior and structural properties of an anatomic tendon reconstruction of the coracoclavicular ligament complex after a simulated acromioclavicular joint dislocation. Study Design: Controlled laboratory study. Methods: Cyclic loading followed by a load-to-failure protocol (simulated dislocation) of the normal coracoclavicular ligament complex was performed and repeated after an anatomic reconstruction on the same specimen (n = 9). The anatomical reconstruction consisted of a semitendinosus tendon that replicated the direction and orientation of both the trapezoid and conoid ligaments. Results: The coracoclavicular ligament and anatomical reconstruction complexes had clinically insignificant (