Choice of Acromioclavicular Dislocation Treatment Should Not Be Influenced by Risk of Development of Acromioclavicular Osteoarthritis: A Systematic Review With Meta-Analysis.

IF 1.7 Q2 SURGERY

JBJS Reviews Pub Date : 2024-09-03 eCollection Date: 2024-09-01 DOI:10.2106/JBJS.RVW.24.00085

Roderick J M Vossen, Daniel Verstift, Faridi S Van Etten-Jamaludin, Bryan J Hamans, Michel P J van den Bekerom, Lukas P E Verweij

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引用次数: 0

Abstract

Background: It is currently unknown to what degree surgical or nonoperative treatment of acromioclavicular (AC) dislocation influences the development of osteoarthritis (OA). The aim of this study was to evaluate AC OA after surgical and nonoperative treatment for AC dislocations, compare OA prevalence between treatment options, and compare OA prevalence between the injured and contralateral shoulder.

Methods: Articles reporting on the prevalence of OA after surgical or nonoperative treatment of an AC dislocation with a minimal 2-year follow-up were included. AC OA presence was extracted for the injured and contralateral shoulder. Treatment categories were defined based on anatomical variation in the reattachment of ligaments: AC fixation, coracoclavicular (CC) fixation, AC and CC fixation, Bosworth screw synthetic graft, tendon graft, and conservative. Study quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria.

Results: Ninety-four articles were included for qualitative analysis, and 7 articles were included for meta-analysis (n = 3,812; follow-up = 2.0-24.2 years; mean age 37.6 ± 10.4 years). A total of 3,483 patients underwent surgical treatment, and 329 patients underwent conservative treatment. OA prevalence ranged from 6.7%-29.3% between 7 pooled treatment categories. Most included studies had a follow-up <10 years (94%) and OA prevalence increased with time, regardless of treatment option. There was no difference in OA prevalence between the injured and contralateral shoulder (p = 0.120). MINORS scores were varied, ranging from poor to very good.

Conclusion: The pooled AC OA prevalence of the 7 treatment categories ranged from 6.7% for the CC fixation surgical group to 29.3% for the conservative treatment group. However, the included studies were predominantly of low quality and had varying follow-up periods, with most having relatively short follow-up durations. No difference in AC OA prevalence was found between the injured and contralateral shoulder. Based on the available evidence, treatment choice for AC dislocation should not be influenced by the potential development of AC AO.

Level of evidence: Level IV. See Instructions for Authors for a complete description of levels of evidence.

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肩锁关节脱位治疗方法的选择不应受肩锁关节骨关节炎发病风险的影响：带元分析的系统性综述。

背景：目前尚不清楚肩锁关节（AC）脱位的手术或非手术治疗对骨关节炎（OA）的发展有多大影响。本研究旨在评估手术和非手术治疗肩关节脱位后的肩关节OA，比较不同治疗方案的OA患病率，并比较受伤肩关节和对侧肩关节的OA患病率：方法：本文纳入了报道交流脱位手术或非手术治疗后 OA 患病率的文章，并进行了至少 2 年的随访。提取了受伤肩部和对侧肩部的肩关节OA存在率。根据韧带重新附着的解剖学变化定义治疗类别：AC固定、锁骨（CC）固定、AC和CC固定、博斯沃斯螺钉合成移植、肌腱移植和保守治疗。研究质量采用非随机研究方法指数（MINORS）标准进行评估：共有94篇文章被纳入定性分析，7篇文章被纳入荟萃分析（n = 3,812；随访时间 = 2.0-24.2 年；平均年龄（37.6 ± 10.4）岁）。共有3483名患者接受了手术治疗，329名患者接受了保守治疗。在7个合并治疗类别中，OA发病率介于6.7%-29.3%之间。大多数纳入的研究都有随访结论：7个治疗类别的合并前交叉韧带OA患病率从CC固定手术组的6.7%到保守治疗组的29.3%不等。然而，纳入的研究大多质量不高，随访时间长短不一，大多数随访时间相对较短。受伤肩部和对侧肩部的前交叉韧带损伤患病率没有差异。根据现有证据，治疗前交叉韧带脱位的选择不应受到前交叉韧带损伤的潜在发展的影响：证据等级：IV级。有关证据等级的完整描述，请参阅 "作者须知"。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JBJS Reviews SURGERY-

CiteScore

4.40

自引率

4.30%

发文量

132

期刊介绍： JBJS Reviews is an innovative review journal from the publishers of The Journal of Bone & Joint Surgery. This continuously published online journal provides comprehensive, objective, and authoritative review articles written by recognized experts in the field. Edited by Thomas A. Einhorn, MD, and a distinguished Editorial Board, each issue of JBJS Reviews, updates the orthopaedic community on important topics in a concise, time-saving manner, providing expert insights into orthopaedic research and clinical experience. Comprehensive reviews, special features, and integrated CME provide orthopaedic surgeons with valuable perspectives on surgical practice and the latest advances in the field within twelve subspecialty areas: Basic Science, Education & Training, Elbow, Ethics, Foot & Ankle, Hand & Wrist, Hip, Infection, Knee, Oncology, Pediatrics, Pain Management, Rehabilitation, Shoulder, Spine, Sports Medicine, Trauma.