Anatomic Evaluation of the Safety of a Novel Technique for Acromioclavicular Joint Reconstruction: A Cadaveric Study

Abstract

Knowledge of the anatomical variation of the features surrounding the suprascapular notch is crucial to patient safety in a novel surgical procedure for acromioclavicular (AC) joint reconstruction. Acromioclavicular joint separation is one of the most commonly occurring shoulder injuries of the shoulder girdle. Many procedures exist to anatomically reconstruct a separated AC joint, but there is no “gold standard” procedure. The purpose of this study was to examine the proximity of a novel, minimally invasive technique for AC joint reconstruction to surrounding neurovasculature. The arthroscopic reconstruction was performed on six cadaveric shoulders. The shoulders were dissected and the closest distance from adjacent neurovasculature to implanted materials was observed and measured in each specimen. The closest neurovascular structures to implanted materials were observed to be the suprascapular nerve and suprascapular artery as they passed adjacent to the medial coracoid, anterior to the suprascapular notch. The mean distances were 8.23 (SD = 3.60) mm to the suprascapular nerve and 5.56 (SD = 4.21) mm to the suprascapular artery. The closest distances observed were 2.16 mm to the nerve and 0.0 mm to the artery. It was noted that suprascapular nerves with a more lateral origin tended to pass closer to the medial coracoid, and thus closer to the operative field. It was concluded that the distance from the suprascapular artery and nerve to the medial coracoid is variable, and these structures may lie in close proximity to the operative field for this procedure.