The ligamentous structures of the acromioclavicular joint were studied
by gross examination and quantitative measurement in twelve human cadaver
specimens. Distances between insertions at various extreme positions of the
clavicle were studied with the biplane radiographic technique. Ligamentous
contributions to joint constraint under displacements were determined by
performing load-displacement tests along with sequential sectioning of the
ligaments. Twelve modes of joint displacement were examined. The
acromioclavicular ligament acted as a primary constraint for posterior
displacement of the clavicle and posterior axial rotation. The conoid
ligament appeared to be more important than has been previously described.
That ligament played a primary role in constraining anterior and superior
rotation as well as anterior and superior displacement of the clavicle. The
trapezoid ligament contributed less constraint to movement of the clavicle
in both the horizontal and the vertical plane except when the clavicle
moved in axial compression toward the acromion process. The various
contributions of different ligaments to constraint changed not only with
the direction of joint displacement but also with the amount of loading and
displacement. For many directions of displacement, the acromioclavicular
joint contributed a greater amount to constraint at smaller degrees of
displacement, while the coracoclavicular ligaments, primarily the conoid
ligament, contributed a greater amount of constraint with larger amounts of
displacement.