Abstract
Background
The most appropriate approach, surgical or conservative, for acute Rockwood type III
acromioclavicular joint (ACJ) dislocation is still under debate. In literature, similar
results have been reported with both treatments. This review aims to analyze the operative
and conservative outcomes of acute Rockwood type III ACJ dislocation to guide orthopedics
in daily practice.
Material/methods
A systematic review and meta-analysis were performed according to PRISMA guidelines.
A PICOS template was developed. Four databases (Pubmed, Scopus, Embase, and Medline)
were searched, and eligible articles were evaluated according to the Levels of Evidence.
The methodological quality of the articles was assessed through the ROBINS-I and the
RoB-2. This review was registered in PROSPERO.
Results
Five studies were included, with 73 and 110 patients treated with conservative and
surgical approaches, respectively. Three outcomes, Constant Score (CS), coracoclavicular
distance (CCD), and acromioclavicular distance (ACD) were analyzed. Only the acromioclavicular
distance was statistically significant in the surgical group over the conservative
one (p < 0.05); instead, the other two outcomes demonstrated no statistical difference
between the two groups.
Conclusions
This study demonstrated statistically significant superiority of the mean ACD score
in the radiological follow-up of the surgical group compared to the conservative one.
A tendency for better radiological and clinical results, mean CCD and CS scores, respectively,
although non statically significant, was reported in the surgical group. High-quality
randomized controlled clinical trials should help determine the most appropriate treatment
for acute Rockwood type III ACJ dislocations.
Keywords
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Article info
Publication history
Published online: August 02, 2022
Accepted:
July 31,
2022
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
