{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T02:23:48Z","timestamp":1789957428620,"version":"4.0.1"},"reference-count":43,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,8,19]],"date-time":"2020-08-19T00:00:00Z","timestamp":1597795200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To reconstruct the acromioclavicular (AC) joint using an adjusted closed\u2010loop double Endobutton technique <jats:italic>via<\/jats:italic> a guiding locator that was applied using three\u2010dimensional (3D) printing technology. At the same time, the reliability and safety of the novel double Endobutton (NDE) were tested by comparing the biomechanics of this technique with the TightRope (TR) approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study was conducted between January 2017 and January 2019. The Department of Anatomy at Southern Medical University obtained 18 fresh\u2010frozen specimens (8 left and 10 right; 12 men and 6 women). First, the guiding locators were applied using 3D printing technology. After preparation of materials, specimens were divided into an NDE group, a TR group, and a normal group. In the NDE and TR groups, the navigation module was used to locate and establish the bone tunnels; after that, the NDE or TR was implanted. However, the Endobuttons were fixed while pressing the distal clavicle downwards and the length of the loop could be adjusted by changing the upper Endobutton in the NDE group while the suture button construct was tensioned and knotted after pressing down the distal clavicle in the TR. Finally, load testing in anterior\u2013posterior (AP), superior\u2013inferior (SI), and medial\u2013lateral (ML) directions as well as load\u2010to\u2010failure testing in the SI direction were undertaken to verify whether the NDE or TR had better biomechanics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the load testing, the displacements of the NDE and TR groups in the AP, SI, and ML direction were significantly shorter than those of the normal group (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). In the load\u2010to\u2010failure testing, the ultimate load of the NDE and TR groups had significantly higher increases than the normal group (722.16\u2009\u00b1\u200992.04 <jats:italic>vs<\/jats:italic> 564.63\u2009\u00b1\u200963.05, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05; 680.20\u2009\u00b1\u2009110.29 <jats:italic>vs<\/jats:italic> 564.63\u2009\u00b1\u200963.05, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). However, there was no statistically significant difference between the two techniques for these two tests (<jats:italic>P<\/jats:italic>\u2009&gt;\u20090.05). In the NDE group, four of six failures were a result of tunnel fractures of the coracoid, while two of six were due to suture breakage. In the TR, three failures were due to coracoid tunnel fractures, one was a result of a clavicle tunnel fracture, and the rest were due to suture breakage. In the normal group, half of the failures were a result of avulsion fractures of the conical ligament at the point of the coracoid process, and the other three were due to rupture of the conical ligament, fracture of the distal clavicle, and fracture of the scapular body.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>As for the TR technique, the stability and strength of the AC joint were better in patients who underwent reconstruction using the NDE technique than in the intact state.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.12770","type":"journal-article","created":{"date-parts":[[2020,8,28]],"date-time":"2020-08-28T05:27:50Z","timestamp":1598592470000},"page":"1511-1519","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Novel Double Endobutton Technique Combined with Three\u2010Dimensional Printing: A Biomechanical Study of Reconstruction in Acromioclavicular Joint Dislocation"],"prefix":"10.1111","volume":"12","author":[{"given":"Lei","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Orthopaedics Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University  Luzhou China"},{"name":"Center for Orthopaedic Diseases Research Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University  Luzhou China"},{"name":"Academician Workstation Guangdong Province Medical 3D Printing Application Transformation Engineering Technology Research Center  Luzhou China"},{"name":"Clinical Base of Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University Guangdong Province Medical 3D Printing Application Transformation Engineering Technology Research Center  Luzhou China"},{"name":"National Key Discipline of Human Anatomy School of Basic Medical Sciences, Southern Medical University  Guangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ai\u2010ni","family":"He","sequence":"additional","affiliation":[{"name":"Academician Workstation Guangdong Province Medical 3D Printing Application Transformation Engineering Technology Research Center  Luzhou China"},{"name":"School of Clinical Medicine Southwest Medical University  Luzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu\u2010feng","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Luzhou Traditional Chinese Medicine Hospital  Luzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han\u2010wen","family":"Cheng","sequence":"additional","affiliation":[{"name":"Academician Workstation Guangdong Province Medical 3D Printing Application Transformation Engineering Technology Research Center  Luzhou China"},{"name":"School of Clinical Medicine Southwest Medical University  Luzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University  Luzhou China"},{"name":"Center for Orthopaedic Diseases Research Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University  Luzhou China"},{"name":"Academician Workstation Guangdong Province Medical 3D Printing Application Transformation Engineering Technology Research Center  Luzhou China"},{"name":"Clinical Base of Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University Guangdong Province Medical 3D Printing Application Transformation Engineering Technology Research Center  Luzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hua\u2010qiang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Luzhou Traditional Chinese Medicine Hospital  Luzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun\u2010jie","family":"Yao","sequence":"additional","affiliation":[{"name":"Academician Workstation Guangdong Province Medical 3D Printing Application Transformation Engineering Technology Research Center  Luzhou China"},{"name":"School of Clinical Medicine Southwest Medical University  Luzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University  Luzhou China"},{"name":"Center for Orthopaedic Diseases Research Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University  Luzhou China"},{"name":"Academician Workstation Guangdong Province Medical 3D Printing Application Transformation Engineering Technology Research Center  Luzhou China"},{"name":"Clinical Base of Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University Guangdong Province Medical 3D Printing Application Transformation Engineering Technology Research Center  Luzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,8,19]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2017.05.032"},{"key":"e_1_2_5_3_1","first-page":"CD007429","article-title":"Surgical versus conservative interventions for treating acromioclavicular dislocation of the shoulder in adults [published online ahead of print, 2019 Oct 11]","volume":"10","author":"Tamaoki MJ","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2012.01.020"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546506298022"},{"key":"e_1_2_5_6_1","first-page":"6804670","article-title":"Migration of a broken Kirschner wire after surgical treatment of acromioclavicular joint dislocation","volume":"2016","author":"Bat\u0131n S","year":"2016","journal-title":"Case Rep Surg"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-014-2117-2"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2012.03.003"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-014-3294-9"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2011.08.003"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.2174\/1874325001610010166"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546508323255"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2019.06.007"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eats.2015.02.012"},{"key":"e_1_2_5_15_1","first-page":"1","article-title":"The tight\u2010rope technique versus clavicular hook plate for treatment of acute acromioclavicular joint dislocation: a systematic review and meta\u2010analysis","volume":"2019","author":"Qi W","year":"2019","journal-title":"J Invest Surg"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/BTE.0b013e31815907a3"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546515596409"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2017.11.032"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2011.12.008"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546512445273"},{"key":"e_1_2_5_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2017.03.033"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2017.12.009"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2017.12.015"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2019.09.002"},{"key":"e_1_2_5_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1058-2746(03)00029-6"},{"key":"e_1_2_5_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/2325967116674668"},{"key":"e_1_2_5_27_1","first-page":"247","article-title":"Biomechanical evaluation of a new technique for acromioclavicular stabilization","volume":"106","author":"Peeters I","year":"2020","journal-title":"OrthopTraumatol Surg Res"},{"key":"e_1_2_5_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-005-0073-6"},{"key":"e_1_2_5_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otsr.2015.09.012"},{"key":"e_1_2_5_30_1","first-page":"1264","article-title":"Vertical and rotational stiffness of coracoclavicular ligament reconstruction: a biomechanical study of 3 different techniques","volume":"36","author":"Celik H","year":"2020","journal-title":"Art Ther"},{"key":"e_1_2_5_31_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546518807908"},{"key":"e_1_2_5_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-019-05742-6"},{"key":"e_1_2_5_33_1","first-page":"108","article-title":"Reconstruction of the acromioclavicular ligament complex using dermal allograft: a biomechanical analysis","volume":"36","author":"Morikawa D","year":"2020","journal-title":"Art Ther"},{"key":"e_1_2_5_34_1","doi-asserted-by":"publisher","DOI":"10.1067\/mse.2001.118480"},{"key":"e_1_2_5_35_1","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20130920-20"},{"key":"e_1_2_5_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-014-3198-8"},{"key":"e_1_2_5_37_1","first-page":"1349","article-title":"Tunnel enlargement after double\u2010bundle anterior cruciate ligament reconstruction: a prospective, randomized study","volume":"24","author":"J\u00e4rvel\u00e4 T","year":"2008","journal-title":"Art Ther"},{"key":"e_1_2_5_38_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546504264637"},{"key":"e_1_2_5_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/rcs.2057"},{"key":"e_1_2_5_40_1","first-page":"2983","article-title":"Biomechanical analysis of single\u2010, double\u2010, and triple\u2010bundle configurations for coracoclavicular ligament reconstruction using cortical fixation buttons with suture tapes: a cadaveric study","volume":"34","author":"Park I","year":"2018","journal-title":"Art Ther"},{"key":"e_1_2_5_41_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546514524159"},{"key":"e_1_2_5_42_1","first-page":"982","article-title":"Effect of coracoid drilling for acromioclavicular joint reconstruction techniques on coracoid fracture risk: a biomechanical study","volume":"32","author":"Martetschl\u00e4ger F","year":"2016","journal-title":"Art Ther"},{"key":"e_1_2_5_43_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-019-05731-9"},{"key":"e_1_2_5_44_1","first-page":"119","article-title":"Early failure of coracoclavicular ligament reconstruction using TightRope system","volume":"82","author":"Singh B","year":"2016","journal-title":"Acta Orthop Belg"}],"container-title":["Orthopaedic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.12770","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/os.12770","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.12770","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,4]],"date-time":"2023-09-04T12:16:47Z","timestamp":1693829807000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/os.12770"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,19]]},"references-count":43,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2020,10]]}},"alternative-id":["10.1111\/os.12770"],"URL":"https:\/\/doi.org\/10.1111\/os.12770","archive":["Portico"],"relation":{},"ISSN":["1757-7853","1757-7861"],"issn-type":[{"value":"1757-7853","type":"print"},{"value":"1757-7861","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,19]]},"assertion":[{"value":"2020-06-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-07-09","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-08-19","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}