Chaudhury Salma, Bavan Luckshman, Rupani Neal, Mouyis Kyriacos, Kulkarni Ro, Rangan Amar, Rees Jonathan
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Surgery, Nuffield Orthopaedic Center, University of Oxford, Oxford, UK.
Royal Gwent Hospital, Wales, UK.
Shoulder Elbow. 2018 Jan;10(1):4-14. doi: 10.1177/1758573217700839. Epub 2017 Apr 9.
Shoulder pain secondary to acromioclavicular joint pain is a common presentation in primary and secondary care but is often poorly managed as a result of uncertainty about optimal treatment strategies. Osteoarthritis is the commonest cause. Although acromioclavicular pain can be treated non-operatively and operatively, there appears to be no consensus on the best practice pathway of care for these patients, with variations in treatment being common place. The present study comprises a scoping review of the current published evidence for the management of isolated acromioclavicular pain (excluding acromioclavicular joint dislocation).
A comprehensive search strategy was utilized in multiple medical databases to identify level 1 and 2 randomised controlled trials, nonrandomised controlled trials and systematic reviews for appraisal.
Four systematic reviews and two randomised controlled trials were identified. No direct studies have compared the benefits or risks of conservative versus surgical management in a controlled environment.
High-level studies on treatment modalities for acromioclavicular joint pain are limited. As such, there remains little evidence to support one intervention or treatment over another, making it difficult to develop any evidenced-based patient pathways of care for this condition.Level of evidence: 2A.
继发于肩锁关节疼痛的肩部疼痛在初级和二级医疗保健中很常见，但由于最佳治疗策略存在不确定性，其管理往往不佳。骨关节炎是最常见的原因。尽管肩锁关节疼痛可通过非手术和手术治疗，但对于这些患者的最佳护理实践路径似乎没有共识，治疗方法差异很大。本研究包括对当前已发表的关于孤立性肩锁关节疼痛（不包括肩锁关节脱位）管理证据的范围审查。
在多个医学数据库中采用综合检索策略，以识别用于评估的1级和2级随机对照试验、非随机对照试验和系统评价。
识别出四项系统评价和两项随机对照试验。没有直接研究在对照环境中比较保守治疗与手术治疗的益处或风险。
关于肩锁关节疼痛治疗方式的高水平研究有限。因此，几乎没有证据支持一种干预或治疗优于另一种，这使得难以制定基于证据的针对这种情况的患者护理路径。证据级别：2A。
