{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T10:54:52Z","timestamp":1788864892938,"version":"build-2803163510"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,3,17]],"date-time":"2023-03-17T00:00:00Z","timestamp":1679011200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2023,3,17]],"date-time":"2023-03-17T00:00:00Z","timestamp":1679011200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2023,3,17]],"date-time":"2023-03-17T00:00:00Z","timestamp":1679011200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,3,17]],"date-time":"2023-03-17T00:00:00Z","timestamp":1679011200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2023,2,6]],"date-time":"2023-02-06T00:00:00Z","timestamp":1675641600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["arthroscopysportsmedicineandrehabilitation.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy, Sports Medicine, and Rehabil."],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To determine the location of coracoid inferior tunnel exit with superior\u2010based tunnel drilling and coracoid superior tunnel exit with inferior\u2010based tunnel drilling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Fifty\u2010two cadaveric embalmed shoulders (mean age 79 years, range 58\u201096 years) were used. A transcoracoid tunnel was drilled at the center of the base. Twenty\u2010six shoulders were used for the superior\u2010to\u2010inferior tunnel drilling approach and 26 shoulders for the inferior\u2010to\u2010superior tunnel drilling approach. The distances to the margins of the coracoid process, from both the entry and exit points of the tunnel, were measured. Paired Student\n                      <jats:italic>t<\/jats:italic>\n                      \u2010tests were used to compare the distance from the center of the tunnel and the medial and lateral coracoid border and the apex.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean difference for the distances between superior entry and inferior exit from the apex was 3.65 \u00b1 3.51 mm (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .002); 1.57 \u00b1 2.27 mm for the lateral border (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .40) and 5.53 \u00b1 3.45 mm for the medial border (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .001). The mean difference for the distances between inferior entry and superior exit from the apex was 16.95 \u00b1 3.11 mm (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .0001); 6.51 \u00b1 3.2 mm for the lateral border (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .40) and 1.03 \u00b1 2.32 mm for the medial border (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0= .045). Inferior\u2010to\u2010superior drilling resulted in 4 (15%) cortical breaks.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Both superior\u2010to\u2010inferior and inferior\u2010to\u2010superior tunnel drilling directed the tunnel from a more anterior and medial entry to a posterior\u2013lateral exit. Superior\u2010to\u2010inferior drilling resulted in a more posteriorly angled tunnel. When using a 5\u2010mm reamer and inferior\u2010to\u2010superior tunnel drilling, cortical breaks were observed at the inferior and medial margin of the tunnel exit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Relevance<\/jats:title>\n                    <jats:p>Arthroscopic\u2010assisted acromioclavicular joint reconstruction using conventional jigs may result in an eccentric coracoid tunnel, possibly introducing stress risers and fractures. To avoid cortical breaks and eccentric tunnel placement, open drilling from superior\u2010to\u2010inferior with a superiorly centered guide pin and arthroscopic visualization of a centered inferior exit should be considered.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.asmr.2023.01.019","type":"journal-article","created":{"date-parts":[[2023,3,17]],"date-time":"2023-03-17T20:22:35Z","timestamp":1679084555000},"update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":6,"title":["Transcoracoid Drilling for Coracoclavicular Ligament Reconstructions in Patients With Acromioclavicular Joint Dislocations Result in Eccentric Tunnels"],"prefix":"10.1002","volume":"5","author":[{"given":"Erik","family":"Hohmann","sequence":"first","affiliation":[{"name":"Burjeel Hospital for Advanced Surgery Dubai United Arab Emirates"},{"name":"School of Medicine University of Pretoria South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sinmiloluwa","family":"Oduoye","sequence":"additional","affiliation":[{"name":"Department of Anatomy School of Medicine Faculty of Health Sciences University of Pretoria South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jolandie","family":"Myburgh","sequence":"additional","affiliation":[{"name":"Department of Anatomy School of Medicine Faculty of Health Sciences University of Pretoria South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reinette","family":"van Zyl","sequence":"additional","affiliation":[{"name":"Department of Anatomy School of Medicine Faculty of Health Sciences University of Pretoria South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Keough","sequence":"additional","affiliation":[{"name":"Department of Anatomy and Cellular Biology College of Medicine &amp; Health Sciences Khalifa University Abu Dhabi United Arab Emirates"},{"name":"Department of Anatomy University of Pretoria Pretoria South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,3,17]]},"reference":[{"key":"e_1_2_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jseint.2020.01.009"},{"key":"e_1_2_2_3_2","article-title":"Epidemiology of isolated acromioclavicular joint dislocation","volume":"2012","author":"Chillemi C.","year":"2013","journal-title":"Emerg Med Int"},{"key":"e_1_2_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2013.11.005"},{"key":"e_1_2_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2017.11.033"},{"key":"e_1_2_2_6_2","first-page":"565","article-title":"Results of operative and nonoperative treatment of Rockwood types III and V acromioclavicular joint dislocation: A prospective, randomized trial with an 18\u2010 to 20\u2010year follow\u2010up","volume":"26","author":"Joukainen A.","year":"2014","journal-title":"Orthop J Sports Med"},{"key":"e_1_2_2_7_2","first-page":"27","article-title":"Optimal management of acromioclavicular dislocation: Current perspectives","volume":"12","author":"Nolte P.C.","year":"2020","journal-title":"Orthop Res Rev"},{"key":"e_1_2_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2013.06.022"},{"key":"e_1_2_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2018.01.028"},{"key":"e_1_2_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2011.12.008"},{"key":"e_1_2_2_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546512445273"},{"key":"e_1_2_2_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546513502459"},{"key":"e_1_2_2_13_2","article-title":"Anatomy and correlation of the coracoid process and coracoclavicular ligament based on three\u2010dimensional computed tomography reconstruction and magnetic resonance imaging","volume":"27","author":"Xin L.","year":"2021","journal-title":"Med Sci Mon"},{"key":"e_1_2_2_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546518795147"},{"key":"e_1_2_2_15_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546519858745"},{"key":"e_1_2_2_16_2","doi-asserted-by":"crossref","unstructured":"Marsalli M Moran N Laso JI. 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