A novel hybrid fixation (coracoclavicular screw supplemented with K-wire) for the treatment of acute acromioclavicular joint dislocation: A prospective study

Zheng, Junju; Chen, Jiaru; Chen, Lin; Ni, Yue-ping; Zhou, Lin

doi:10.1016/j.ijsu.2018.09.019

Cited by 5 publications

(16 citation statements)

References 32 publications

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“…Since Rockwood's classification of ACJ is based on the degree and direction of clavicle displacement, reconstruction of the CC ligament is the most commonly applied clinical surgical strategy 3,4 . Although Bosworth screws have been reported in the literature in addition to the five surgical procedures included in this study, after a careful review of the literature we found that few studies met the criteria and no valid data were available 55–57 . Notably, in addition to CC reconstruction, AC reconstruction (tension band wires, Kirschner wires, or sutures), 8,58 AC and CC reconstruction (Weaver–Dunn procedures) 59 are also options for surgical treatment.…”

Section: Discussionmentioning

confidence: 92%

Comparison of Effectiveness and Safety in Treating Acute Acromioclavicular Joint Dislocation with Five Different Surgical Procedures: A Systematic Review and Network Meta‐Analysis

Yan

Liao

Lai

et al. 2023

Orthopaedic Surgery

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This network meta‐analysis aims to evaluate the comparative effectiveness and safety of suture anchors (SA), tendon grafts (TG), hook plates (HP), Tight‐Rope (TR), and EndoButton (EB) in the treatment of acute acromioclavicular joint (ACJ) dislocation. The Embase, PubMed, and Web of Science databases were searched from their inception date to June 3, 2022. Studies included all eligible randomized controlled trials (RCTs) and cohort studies with the comparison of five different fixation systems among SA, TG, HP, TR, and EB were identified. All studies were reviewed, performed data extraction, and assessed the risk of bias independently by two reviewers. The primary outcomes are Constant–Murley score (CMS) improvement for assessing clinical efficacy, and complications. The second outcomes are visual analog scale (VAS) for assessing pain relief and the coracoclavicular distance (CCD) for assessing postoperative joint reduction. Version 2 of the revised Cochrane risk of bias tool for randomized trials (RoB 2) and the risk of bias in nonrandomized studies of interventions (ROBINS‐I) were used to assess the RCTs and non‐randomized trials, respectively. The continuous outcomes were presented as mean differences (MD), and risk ratios (OR) were used for dichotomous outcomes, both with 95% confidence intervals (CI). Surface under the cumulative ranking curves (SUCRA) results were calculated to offer a ranking of each intervention. We identified 31 eligible trials, including 1687 patients in total. HP showed less CMS improvement than TR and EB in both the Network Meta‐analysis (NMA) and pairwise meta‐analysis. HP also showed less CMS improvement than SA in NMA. For pain relief, HP performed worse than TR both in pairwise meta‐analysis and NMA. No significant differences were found for the measured value of CCD. Both TR and EB showed a lower incidence of complications than HP in pairwise meta‐analysis. The rank of SUCRA for CMS improvement was as follows: SA, TR, EB, TG, and HP; for pain relief: TR, EB, TG, SA, and HP; for CCD: HP, TR, SA, EB, and TG. For complications, HP showed the highest rank, followed by TG, EB, TR, and SA. SA shows better clinical effectiveness and reliable safety in the treatment of acute ACJ dislocation. Although HP is the most widely used surgical option currently, it should be carefully taken into consideration for its high incidence of complications.

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Section: Discussionmentioning

confidence: 92%

Comparison of Effectiveness and Safety in Treating Acute Acromioclavicular Joint Dislocation with Five Different Surgical Procedures: A Systematic Review and Network Meta‐Analysis

Yan

Liao

Lai

et al. 2023

Orthopaedic Surgery

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“…One thousand six‐hundred and fifty shoulders suffered from a Rockwood type‐III dislocation, 420 shoulders a type‐IV dislocation, and 1614 shoulders a type‐V dislocation. Patients underwent surgery within 1 week from dislocation in 20 studies [4, 41, 43, 49, 51, 56, 57, 75, 76, 78, 81, 82, 91, 138, 148, 151, 152, 156, 160, 176], 2 weeks in 52 studies [5, 7, 9, 10, 15, 19, 21, 30, 34–36, 44, 46, 58–60, 67, 70, 71, 87–90, 94, 97, 98, 105, 106, 108, 111, 122, 125–127, 129, 135, 139, 144, 147, 149, 153, 155, 158, 161, 162, 165, 166, 170–172, 174, 177], 3 weeks in 31 studies [2…”

Section: Resultsmentioning

confidence: 99%

“…Loss of reduction was reported on X‐rays in 116 studies [2, 4, 7, 10, 12–15, 17–23, 25, 29, 30, 32–41, 43, 45, 46, 49–52, 54–61, 64–67, 69–73, 75–77, 86–88, 90–92, 94, 95, 97, 98, 102–104, 106–109, 111, 117, 118, 122–130, 133, 135, 137–139, 143, 144, 146–154, 156, 158, 160–162, 165–167, 170–177], computed tomography (CT) was used in one study...…”

Section: Resultsmentioning

confidence: 99%

“…45 [4, 5, 9, 10, 13, 14, 18, 19, 30, 32, 38, 39, 43, 49, 58–61, 65, 70, 75, 79–81, 86, 88, 90, 93, 98, 99, 105, 109, 113, 129, 135, 139, 144, 153, 158, 160, 161, 172, 173, 175, 177]…”

Section: Resultsmentioning

confidence: 99%

“…Eighty-two non-comparative studies [2, 4, 7, 8, 12, 15, 17, 20, 22, 23, 25, 29, 32, 33, 36-41, 45, 46, 50-52, 54, 55, 57, 58, 64, 66, 67, 72, 73, 75, 76, 82, 86-90, 95, 97, 99, 102, 103, 111, 113, 117, 118, 120, 122-124, 126-128, 130, 133, 137, 139, 143, 146-154, 158, 161, 162, 165-167, 171, 172, 174, 176] were at high risk of bias and only six [56,70,71,78,92,104] were at low risk of bias; 34 comparative studies [5, 10, 13, 18, 19, 21, 34, 35, 43, 44, 49, 59, 60, 69, 77, 79-81, 91, 93, 94, 98, 106-109, 125, 144, 155, 156, 160, 170, 173, 175] were at high risk of bias, while only 11 [1,9,14,30,61,65,105,129,134,138,177] were at low risk of bias.…”

Section: Risk Of Bias Within Studiesmentioning

confidence: 99%

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Biologic and synthetic ligament reconstructions achieve better functional scores compared to osteosynthesis in the treatment of acute acromioclavicular joint dislocation

Saccomanno

Sircana

Cardona

et al. 2020

Knee Surg Sports Traumatol Arthrosc

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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.

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Treatment options for acute Rockwood type III-V acromioclavicular dislocations: a network meta-analysis of randomized controlled trials

Bi¹,

Robinson

Anil³

et al. 2023

Journal of Shoulder and Elbow Surgery

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A novel hybrid fixation (coracoclavicular screw supplemented with K-wire) for the treatment of acute acromioclavicular joint dislocation: A prospective study

Cited by 5 publications

References 32 publications

Comparison of Effectiveness and Safety in Treating Acute Acromioclavicular Joint Dislocation with Five Different Surgical Procedures: A Systematic Review and Network Meta‐Analysis

Comparison of Effectiveness and Safety in Treating Acute Acromioclavicular Joint Dislocation with Five Different Surgical Procedures: A Systematic Review and Network Meta‐Analysis

Biologic and synthetic ligament reconstructions achieve better functional scores compared to osteosynthesis in the treatment of acute acromioclavicular joint dislocation

Treatment options for acute Rockwood type III-V acromioclavicular dislocations: a network meta-analysis of randomized controlled trials

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