Allo- and autografts show comparable outcomes in chronic acromioclavicular joint reconstruction: a systematic review

Eigenschink, Martin; Heuberer, Philipp R.; Pauzenberger, Leo; Garrigues, Grant E.; Achenbach, Leonard; Dimmen, Sigbjørn; Laky, Brenda; Laver, Lior

doi:10.1007/s00167-021-06445-7

Cited by 6 publications

(3 citation statements)

References 60 publications

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“…Eigenschink et al reported, in a recent systematic review, that there are no significant differences in clinical outcomes, risk of revision surgery, and overall complications between allograft and autograft reconstruction. 51 There may be an increased risk of loss of reduction with allografts versus autografts. However, they reported that the published studies are generally of low quality with low levels of evidence.…”

Section: Resultsmentioning

confidence: 99%

Management of Acromioclavicular Injuries – Current Concepts

Groot¹,

Verstift²,

Heisen³

et al. 2023

ORR

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Introduction Treatment of a patient with acromioclavicular joint (ACJ) injury remains challenging for orthopedic surgeons. To date, there is debate over the optimal management of ACJ injuries. This review provides an overview of assessment, treatment, and future perspectives for the treatment of and research into ACJ. Material and Methods A scoping literature review was performed. The search was built including the following terms: acromioclavicular joint injuries or dislocation, and pathophysiology, etiology, anatomy, treatment, and trauma mechanism. The papers with evidence levels 1–3 were included in the current narrative review. Results A total of 2242 potential relevant studies were identified in the searches. After removal of duplicates, 432 studies were screened on their titles and abstracts, resulting in 35 studies being included in the review, based on the eligibility criteria. Conclusion The management of acute and chronic ACJ injuries is not clarified in the current literature. However, there is currently insufficient high-level evidence for the overall treatment options for ACJ injuries. If surgical intervention is decided upon in consultation with the patient, the complications may not outweigh the benefits. The multitude of existing techniques is indicative of the uncertainty surrounding this issue, and no gold standard has yet been established for treatment methods. An ideal classification would include not only vertical and horizontal instability, but also the severity of kinematic alterations of the shoulder complex. This indicates the need for a new and improved diagnostic tool for the classification of ACJ injuries.

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Section: Resultsmentioning

confidence: 99%

Management of Acromioclavicular Injuries – Current Concepts

Groot¹,

Verstift²,

Heisen³

et al. 2023

ORR

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show abstract

“…Allograft was used instead of autograft by surgeons in this retrospective study due to the increased availability of allograft, the lack of donor-site morbidity, and the similarity in postoperative outcomes between allograft and autograft. 28 Patients with grade III AC joint separations were typically indicated for surgery if horizontal instability with cross-body adduction was observed. Postoperatively all patients received the same standardized rehabilitation regiment regardless of graft use, fixation type, and sport participation.…”

Section: Methodsmentioning

confidence: 99%

Clinical and Patient-Reported Outcomes for Acute Acromioclavicular Joint Fixation are Similar With or Without Allograft Augmentation

Paul

Aman

Kemler

et al. 2022

Arthroscopy, Sports Medicine, and Rehabilitation

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“…Third, in the CCR article, different types of ligament grafts were included among the articles reviewed in this study, which may have led to within-group differences. A recent systemic review revealed that allo-and autografts had comparable outcomes in chronic acromioclavicular joint reconstruction [50], and another study revealed comparable functional results between anatomical synthetic and biologic reconstructions [51].…”

Section: Limitationsmentioning

confidence: 99%

Does Weaver–Dunn procedure have a role in chronic acromioclavicular dislocations? A meta-analysis

et al. 2022

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Background In treatment of chronic acromioclavicular (AC) joint dislocations, both the Weaver–Dunn procedure (WD) and CC ligament reconstruction (CCR) are recommended options due to the low possibility of healing of the coracoclavicular (CC) ligaments. The aim of this review was to determine whether CCR will yield favorable clinical and radiographic outcomes in the treatment of chronic AC dislocations. Method The Cochrane Library, EMBASE, and PubMed databases were searched for literature on chronic AC dislocations from data inception to June 30, 2021. Patient data were pooled using standard meta-analytic approaches. The Cochrane-Mantel–Haenszel method and variance-weighted means were used to analyze the outcomes. The Review Manager version 5.3 software (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark) was used to calculate the heterogenicity, mean difference, and relative risk (RR) for all outcomes in the meta-analysis. Results The current analysis included four trials on this topic, and all AC joint dislocations were classified as Rockwood types III to VI. The pooled data showed that the CCR group had significantly better post-operative American Shoulder and Elbow Surgeons Shoulder (ASES) scores, Oxford Shoulder Scores (OSSs), and Nottingham Clavicle Scores (NCSs) than the WD group, with a significant difference (p < 0.001, p = 0.020, and p < 0.001, respectively). In terms of the post-operative Constant-Murley Scores (CMSs), there were no significant differences between the CCR group and the WD group (p = 0.100). The CCR group had significantly better post-operative abduction and flexion of the index shoulder than the WD group (p < 0.001 and p < 0.001, respectively). In terms of radiological outcomes, the post-operative coracoclavicular distance (CCD) with a 10 kg load was smaller in the CCR group compared to that in the WD group (p < 0.001). The overall surgical wound infection rate was 11.6% in the WD group and 12.9% in the CCR, respectively (p = 0.82). Conclusion The CCR group had better clinical outcome scores in the ASES, OOS, NCS, abduction, flexion, and external rotation than the WD group. In terms of radiological outcomes, the CCR group showed less displacement in weight-loaded post-CCD than the WD group, which indicated that the CCR provided more stability and resistance to deformation forces.

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Allo- and autografts show comparable outcomes in chronic acromioclavicular joint reconstruction: a systematic review

Cited by 6 publications

References 60 publications

Management of Acromioclavicular Injuries – Current Concepts

Management of Acromioclavicular Injuries – Current Concepts

Clinical and Patient-Reported Outcomes for Acute Acromioclavicular Joint Fixation are Similar With or Without Allograft Augmentation

Does Weaver–Dunn procedure have a role in chronic acromioclavicular dislocations? A meta-analysis

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