Surgical vs conservative: what is the best treatment of acute Rockwood III acromioclavicular joint dislocation? A systematic review and meta-analysis.

IF 4.3 2区 医学 Q1 ORTHOPEDICS
Efort Open Reviews Pub Date : 2025-03-03 Print Date: 2025-03-01 DOI:10.1530/EOR-2024-0077
Luca Bianco Prevot, Riccardo Accetta, Stefania Fozzato, Philipp Moroder, Giuseppe Basile
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引用次数: 0

Abstract

Purpose: No literature consensus was found about the best treatment of acute Rockwood type III acromioclavicular joint (ACJ) dislocation. In particular, the advantages and disadvantages between conservative treatment and surgery are not sufficiently quantified in the current literature.

Methods: A systematic literature search was conducted using PubMed, Web of Science and Embase in March 2024. We selected studies comparing surgical and conservative treatment in acute Rockwood III ACJ dislocations. The two treatment methods were compared in terms of Constant score; Disabilities of the Arm, Shoulder, and Hand (DASH); American Shoulder and Elbow Surgeons (ASES) score; Acromioclavicular Joint Instability Score (ACJIS); subjective shoulder value (SSV); radiographical findings; reported complications; and return to sports activity. The risk of bias and quality of evidence were assessed using Cochrane guidelines.

Results: A total of 1844 articles were evaluated, and ten were included in the study for a total of 397 patients. The results of the meta-analysis showed no significant differences between the two groups in terms of Constant score (P = 0.31), DASH (P = 0.52), ASES (P = 0.66) and SSV (P = 0.21), while it highlighted a statistically significant difference in terms of ACJIS (P = 0.00) and acromioclavicular (P = 0.00) and coracoclavicular distance (P = 0.00).

Conclusion: The results showed no significant differences in terms of patient-reported or objective functional outcomes between the two treatment groups. Nonetheless, it highlights a difference in terms of radiographical outcomes and type of complications. While surgical intervention is able to improve joint reduction, it adds the risk for surgical complications.

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来源期刊
Efort Open Reviews
Efort Open Reviews Medicine-Orthopedics and Sports Medicine
CiteScore
6.60
自引率
2.90%
发文量
101
审稿时长
13 weeks
期刊介绍: EFORT Open Reviews publishes high-quality instructional review articles across the whole field of orthopaedics and traumatology. Commissioned, peer-reviewed articles from international experts summarize current knowledge and practice in orthopaedics, with the aim of providing systematic coverage of the field. All articles undergo rigorous scientific editing to ensure the highest standards of accuracy and clarity. This continuously published online journal is fully open access and will provide integrated CME. It is an authoritative resource for educating trainees and supports practising orthopaedic surgeons in keeping informed about the latest clinical and scientific advances. One print issue containing a selection of papers from the journal will be published each year to coincide with the EFORT Annual Congress. EFORT Open Reviews is the official journal of the European Federation of National Associations of Orthopaedics and Traumatology (EFORT) and is published in partnership with The British Editorial Society of Bone & Joint Surgery.
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