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Surgical treatments for acute unstable acromioclavicular joint dislocations

Introduction: Surgical treatment is usually recommended for acute, high-grade acromioclavicular joint (ACJ) injuries. A wide variety of surgical techniques exist, and the literature does not strongly support one over the other. In this literature review, we describe and compare the results of differ...

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Autores principales: Saraglis, Georgios, Prinja, Aditya, To, Kendrick, Khan, Wasim, Singh, Jagwant
Formato: Online Artículo Texto
Lenguaje:English
Publicado: EDP Sciences 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9450493/
https://www.ncbi.nlm.nih.gov/pubmed/36069502
http://dx.doi.org/10.1051/sicotj/2022038
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author Saraglis, Georgios
Prinja, Aditya
To, Kendrick
Khan, Wasim
Singh, Jagwant
author_facet Saraglis, Georgios
Prinja, Aditya
To, Kendrick
Khan, Wasim
Singh, Jagwant
author_sort Saraglis, Georgios
collection PubMed
description Introduction: Surgical treatment is usually recommended for acute, high-grade acromioclavicular joint (ACJ) injuries. A wide variety of surgical techniques exist, and the literature does not strongly support one over the other. In this literature review, we describe and compare the results of different surgical treatments for the management of acute unstable ACJ dislocation and aim to guide surgeons on optimal treatment. Materials and methods: A literature review was performed by searching PubMed, Medline, Cochrane, and Embase databases. Seventeen studies met the inclusion criteria and were analyzed. Only studies with comparative data were included. The clinical and radiological outcomes of these studies were reviewed. Results: Seventeen studies were included in this literature review. We found no difference in outcomes between open and arthroscopic procedures. Coracoclavicular ligament (CCL) reconstruction techniques provide better results than the more rigid hook plate fixation. There is no evidence that biologic repair with tendon graft is superior to synthetic grafts. Furthermore, an autograft is not shown to be better than an allograft. Rigid fixation between the clavicle and coracoid and the non-anatomic Weaver-Dunn technique appears less popular in recent literature. The hook plate is associated with subacromial osteolysis, acromial erosion, and the morbidity of a secondary procedure. Discussion: There is a recent increase in publications on the reconstruction of the ACJ after injury, with new techniques focusing on the anatomic reconstruction of the CCLs aiming to restore both vertical and horizontal plane stability of the ACJ using synthetic/biological grafts. Despite the plethora of new techniques introduced, meaningful comparisons are difficult to draw due to the heterogeneity of the treatments used and the outcome measure used to assess the results.
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spelling pubmed-94504932022-10-03 Surgical treatments for acute unstable acromioclavicular joint dislocations Saraglis, Georgios Prinja, Aditya To, Kendrick Khan, Wasim Singh, Jagwant SICOT J Original Article Introduction: Surgical treatment is usually recommended for acute, high-grade acromioclavicular joint (ACJ) injuries. A wide variety of surgical techniques exist, and the literature does not strongly support one over the other. In this literature review, we describe and compare the results of different surgical treatments for the management of acute unstable ACJ dislocation and aim to guide surgeons on optimal treatment. Materials and methods: A literature review was performed by searching PubMed, Medline, Cochrane, and Embase databases. Seventeen studies met the inclusion criteria and were analyzed. Only studies with comparative data were included. The clinical and radiological outcomes of these studies were reviewed. Results: Seventeen studies were included in this literature review. We found no difference in outcomes between open and arthroscopic procedures. Coracoclavicular ligament (CCL) reconstruction techniques provide better results than the more rigid hook plate fixation. There is no evidence that biologic repair with tendon graft is superior to synthetic grafts. Furthermore, an autograft is not shown to be better than an allograft. Rigid fixation between the clavicle and coracoid and the non-anatomic Weaver-Dunn technique appears less popular in recent literature. The hook plate is associated with subacromial osteolysis, acromial erosion, and the morbidity of a secondary procedure. Discussion: There is a recent increase in publications on the reconstruction of the ACJ after injury, with new techniques focusing on the anatomic reconstruction of the CCLs aiming to restore both vertical and horizontal plane stability of the ACJ using synthetic/biological grafts. Despite the plethora of new techniques introduced, meaningful comparisons are difficult to draw due to the heterogeneity of the treatments used and the outcome measure used to assess the results. EDP Sciences 2022-09-07 /pmc/articles/PMC9450493/ /pubmed/36069502 http://dx.doi.org/10.1051/sicotj/2022038 Text en © The Authors, published by EDP Sciences, 2022 https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0 (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Saraglis, Georgios
Prinja, Aditya
To, Kendrick
Khan, Wasim
Singh, Jagwant
Surgical treatments for acute unstable acromioclavicular joint dislocations
title Surgical treatments for acute unstable acromioclavicular joint dislocations
title_full Surgical treatments for acute unstable acromioclavicular joint dislocations
title_fullStr Surgical treatments for acute unstable acromioclavicular joint dislocations
title_full_unstemmed Surgical treatments for acute unstable acromioclavicular joint dislocations
title_short Surgical treatments for acute unstable acromioclavicular joint dislocations
title_sort surgical treatments for acute unstable acromioclavicular joint dislocations
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9450493/
https://www.ncbi.nlm.nih.gov/pubmed/36069502
http://dx.doi.org/10.1051/sicotj/2022038
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