Giuseppe Sircana1, Maristella F Saccomanno2, Fabrizio Mocini1, Vincenzo Campana1, Piermarco Messinese1, Andrea Monteleone1, Andrea Salvi3, Alessandra Scaini3, Almerico Megaro4, Giuseppe Milano3,4. 1. Orthopaedics Institute, Fondazione Policilinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy. 2. Orthopaedics Institute, Fondazione Policilinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy. maristellasaccomanno@hotmail.it. 3. Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy. 4. Department of Bone and Joint Surgery, Spedali Civili, Brescia, Italy.
Abstract
PURPOSE: To systematically review the outcomes of surgical treatments of chronic acromioclavicular joint dislocation. METHODS: Studies were identified by electronic databases (Ovid, PubMed). All studies reporting functional and radiological outcomes of surgical treatments of chronic acromioclavicular joint dislocations were included. Following data were extracted: authors and year, study design, level of evidence, number of patients, age, classification of acromioclavicular joint dislocation, time to surgery, surgical technique, follow-up, clinical and imaging outcomes, complications and failures. Descriptive statistics was used, when a data pooling was not possible. Comparable outcomes were pooled to generate summary outcomes reported as frequency-weighted values. Quality appraisal was assessed through the MINORS checklist. RESULTS: Fourty-four studies were included for a total of 1020 shoulders. Mean age of participants was 38 years. Mean follow-up was 32.9 months. Arthroscopic techniques showed better results than open approach (p < 0.0001). Synthetic reconstructions demonstrated better functional outcomes compared to internal fixation and biologic techniques (p < 0.0001). Among biologic techniques, combined coracoclavicular and acromioclavicular ligaments reconstruction showed better Constant (p = 0.0270) and ASES (p = 0.0113) scores compared to isolated coracoclavicular ligaments reconstruction; anatomic biologic non-augmented graft reconstruction showed better Constant (p < 0.0001), VAS (p < 0.0001) and SSV (p = 0.0177) results compared to augmented techniques. No differences in functional outcomes could be found between anatomic biologic non-augmented graft versus synthetic reconstructions. Overall, methodological quality of the included studies was low. CONCLUSION: Anatomic reconstructions, both synthetic and biologic, showed the best functional results. LEVEL OF EVIDENCE: IV.
PURPOSE: To systematically review the outcomes of surgical treatments of chronic acromioclavicular joint dislocation. METHODS: Studies were identified by electronic databases (Ovid, PubMed). All studies reporting functional and radiological outcomes of surgical treatments of chronic acromioclavicular joint dislocations were included. Following data were extracted: authors and year, study design, level of evidence, number of patients, age, classification of acromioclavicular joint dislocation, time to surgery, surgical technique, follow-up, clinical and imaging outcomes, complications and failures. Descriptive statistics was used, when a data pooling was not possible. Comparable outcomes were pooled to generate summary outcomes reported as frequency-weighted values. Quality appraisal was assessed through the MINORS checklist. RESULTS: Fourty-four studies were included for a total of 1020 shoulders. Mean age of participants was 38 years. Mean follow-up was 32.9 months. Arthroscopic techniques showed better results than open approach (p < 0.0001). Synthetic reconstructions demonstrated better functional outcomes compared to internal fixation and biologic techniques (p < 0.0001). Among biologic techniques, combined coracoclavicular and acromioclavicular ligaments reconstruction showed better Constant (p = 0.0270) and ASES (p = 0.0113) scores compared to isolated coracoclavicular ligaments reconstruction; anatomic biologic non-augmented graft reconstruction showed better Constant (p < 0.0001), VAS (p < 0.0001) and SSV (p = 0.0177) results compared to augmented techniques. No differences in functional outcomes could be found between anatomic biologic non-augmented graft versus synthetic reconstructions. Overall, methodological quality of the included studies was low. CONCLUSION: Anatomic reconstructions, both synthetic and biologic, showed the best functional results. LEVEL OF EVIDENCE: IV.
Authors: Helena A Boström Windhamre; Johan P von Heideken; Viveka E Une-Larsson; Anders L Ekelund Journal: J Shoulder Elbow Surg Date: 2010-05-10 Impact factor: 3.019
Authors: Knut Beitzel; Elifho Obopilwe; John Apostolakos; Mark P Cote; Ryan P Russell; Ryan Charette; Hardeep Singh; Robert A Arciero; Andreas B Imhoff; Augustus D Mazzocca Journal: Am J Sports Med Date: 2014-07-02 Impact factor: 6.202