Affordable Access

deepdyve-link
Publisher Website

Anatomic reconstruction of the acromioclavicular joint provides the best functional outcomes in the treatment of chronic instability.

Authors
  • Sircana, Giuseppe1
  • Saccomanno, Maristella F2
  • Mocini, Fabrizio1
  • Campana, Vincenzo1
  • Messinese, Piermarco1
  • Monteleone, Andrea1
  • Salvi, Andrea3
  • Scaini, Alessandra3
  • Megaro, Almerico4
  • Milano, Giuseppe3, 4
  • 1 Orthopaedics Institute, Fondazione Policilinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy. , (Italy)
  • 2 Orthopaedics Institute, Fondazione Policilinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy. [email protected] , (Italy)
  • 3 Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy. , (Italy)
  • 4 Department of Bone and Joint Surgery, Spedali Civili, Brescia, Italy. , (Italy)
Type
Published Article
Journal
Knee Surgery Sports Traumatology Arthroscopy
Publisher
Springer-Verlag
Publication Date
Jul 01, 2021
Volume
29
Issue
7
Pages
2237–2248
Identifiers
DOI: 10.1007/s00167-020-06059-5
PMID: 32458032
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

To systematically review the outcomes of surgical treatments of chronic acromioclavicular joint dislocation. 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. 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. Anatomic reconstructions, both synthetic and biologic, showed the best functional results. IV.

Report this publication

Statistics

Seen <100 times