# Multicenter, longitudinal study of acromioclavicular joint reconstruction techniques for restoring shoulder complex biomechanics and soft tissue health

> **NIH NIH R01** · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · 2024 · $704,514

## Abstract

PROJECT SUMMARY:
Acromioclavicular joint (ACJ) injuries are one of the most prevalent shoulder injuries among young athletes
participating in contact sports, which could have long-term impacts on shoulder health and function. ACJ
reconstruction surgery is generally recommended for patients with high-grade injuries. Currently, there is limited
evidence supporting the selection of the optimal surgical technique for these patients. Surgical techniques in this
context can be categorized as rigid and non-rigid fixations. Rigid fixations are falling out of favor with sports
medicine doctors due to their inferior outcomes. Therefore, modern ACJ surgical repairs primarily focus on non-
rigid fixations, which can mimic the native anatomy and function of the disrupted joint better. Within non-rigid
anatomical fixation, two sub-categories can be identified. The first, more conventional sub-category is to
reconstruct only the vertical stabilizers of the ACJ (i.e., coracoclavicular ligaments). Lately, reconstructing the
ACJ capsule and the AC ligaments has received increased attention due to their distinct role in the horizontal
stability of ACJ, which is critical to surgical success and better patient outcomes. So, the second sub-category
emerged that combines acromioclavicular and coracoclavicular reconstruction to stabilize the joint more
completely. However, the benefits of this more complex procedure on shoulder mechanics and soft-tissue health
have yet to be determined (Gap 1). Also, within the combined technique, controversy exists on whether to
perform these repairs using suture techniques with bone tunnels (known to increase clavicle/coracoid fracture
risk) or to employ tunnel-free techniques that reduce the complication risks but may be less effective in restoring
shoulder stability and range of motion (Gap 2).
We address these gaps by a multi-center longitudinal study and test three groups of ACJ reconstructed
patients receiving one of the following surgeries: 1) coracoclavicular reconstruction alone with bone tunnels, 2)
combined coracoclavicular and acromioclavicular reconstruction with, and 3) without bone tunnels. We will use
advanced Dynamic Stereo X-ray and cutting-edge Ultrashort Echo Time Magnetic Resonance Imaging to
compare shoulder mechanics and soft-tissue health between cohorts over time. Our central hypothesis is that
shoulder mechanics and soft-tissue health are better restored with the combined acromioclavicular and
coracoclavicular reconstruction. Also, a less invasive tunnel-free combined reconstruction technique provides
similar outcomes to that with bone tunnels. This research contributes significantly to the following areas: 1) the
effectiveness of critical surgical decisions to reconstruct ACJ will be rigorously examined on shoulder mechanics
and soft tissue health over time to identify the gold-standard treatment. Specifically, we will corroborate: a)
whether to concurrently reconstruct acromioclavicular and coracoclavicular ...

## Key facts

- **NIH application ID:** 10981682
- **Project number:** 1R01AR083471-01A1
- **Recipient organization:** UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
- **Principal Investigator:** Payam Zandiyeh
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $704,514
- **Award type:** 1
- **Project period:** 2024-09-01 → 2029-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10981682

## Citation

> US National Institutes of Health, RePORTER application 10981682, Multicenter, longitudinal study of acromioclavicular joint reconstruction techniques for restoring shoulder complex biomechanics and soft tissue health (1R01AR083471-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10981682. Licensed CC0.

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