Purpose

To systematically review the outcomes of surgical treatments of acute acromioclavicular joint dislocation.

Methods

Studies were identified by electronic databases (Ovid, PubMed). All studies reporting functional and radiological outcomes of surgical treatments of acute 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

One hundred and thirty-three studies were included for a total of 4473 shoulders. Mean age of participants was 36.9 years. Mean follow-up was 42.06 months. Arthroscopy showed better ASES (p < 0.0001) and lower VAS pain score (p = 0.0249) compared to an open approach. Biologic and synthetic reconstructions demonstrated better results over osteosynthesis techniques. Biologic techniques showed overall better Constant (p = 0.0001) and DASH (p = 0.0215) scores, while synthetic reconstruction showed better UCLA score (p = 0.0001). Among suture buttons, triple button showed overall better results in Constant (p = 0.0001) and VAS (p = 0.0001) scores, while better results in DASH score (p = 0.0003) were achieved by 2 double button techniques. Overall, the level of evidence was low.

Conclusion

Biological and synthetic reconstructions achieved better functional scores compared to osteosynthesis. Among suture buttons, the triple button showed better functional performance.

Level of evidence

IV.

中文翻译：

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与接骨术相比，生物和合成韧带重建在治疗急性肩锁关节脱位方面取得了更好的功能评分。

目的

系统评价急性肩锁关节脱位的手术治疗结果。

方法

研究由电子数据库（Ovid、PubMed）确定。所有报告急性肩锁关节脱位手术治疗的功能和放射学结果的研究均被纳入。提取了以下数据：作者和年份、研究设计、证据水平、患者数量、年龄、肩锁关节脱位的分类、手术时间、手术技术、随访、临床和影像学结果、并发症和失败。当数据池不可能时，使用描述性统计。汇总可比较的结果以生成以频率加权值报告的总结结果。质量评估是通过未成年人检查表进行评估的。

结果

共纳入 133 项研究，涉及 4473 个肩膀。参与者的平均年龄为 36.9 岁。平均随访时间为 42.06 个月。 与开放手术相比，关节镜检查显示更好的 ASES ( p  < 0.0001) 和更低的 VAS 疼痛评分 ( p = 0.0249)。生物和合成重建显示出比骨缝合技术更好的结果。生物技术显示总体上更好的 Constant ( p  = 0.0001) 和 DASH ( p  = 0.0215) 评分，而综合重建显示更好的 UCLA 评分 ( p  = 0.0001)。在缝合纽扣中，三纽扣在恒定 ( p  = 0.0001) 和 VAS ( p = 0.0001）分数，而通过 2 个双按钮技术获得了 更好的 DASH 分数结果（p = 0.0003）。总体而言，证据水平较低。

结论

与接骨术相比，生物和合成重建取得了更好的功能评分。缝合纽扣中，三联纽扣表现出更好的功能表现。

证据级别

四．