Coracoclavicular ligament reconstruction using the lateral half of the conjoined tendon

To preserve the coracoacromial (CA) ligament, we have used the lateral half of the conjoined tendon as an autograft source to replace the coracoclavicular (CC) ligament. The purpose of this study is to compare the ultimate tensile strength of the lateral 12 mm of the conjoined tendon with that of the CA ligament and the CC ligament. Eight paired cadaveric male shoulders were tested to tensile failure with a custom pneumatic testing apparatus. Although the lateral 12 mm of the conjoined tendon was stronger than the CA ligament, this difference was not statistically significant (P = .37). However, the intact CC ligament (621 ± 209 N) was approximately 250% stronger than either the lateral 12 mm of the conjoined tendon (265 ± 79 N, P < .001) or the CA ligament (246 ± 69 N, P < .001). We believe that the lateral half of the conjoined tendon is a viable alternative autograft source for reconstruction of the CC ligament in cases of symptomatic acromioclavicular joint dislocation. Though not as strong as the native CC ligaments, the conjoined tendon is slightly stronger than the commonly used CA ligament.