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

Autor: Sircana, Giuseppe, Saccomanno, Maristella F., Mocini, Fabrizio, Campana, Vincenzo, Messinese, Piermarco, Monteleone, Andrea, Salvi, Andrea, Scaini, Alessandra, Megaro, Almerico, Milano, Giuseppe
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Zdroj: Knee Surgery, Sports Traumatology, Arthroscopy; Jul2021, Vol. 29 Issue 7, p2237-2248, 12p, 1 Black and White Photograph, 1 Diagram, 11 Charts
Abstrakt: 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. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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