Unidad de Hombro Y Codo, Hospital Universitario Ramón Y Cajal, Cta Colmenar km 9,100, Madrid, Spain.
Unidad de Bioestadística Clínica, Hospital Ramón Y Cajal, IRYCIS, CIBERESP, Madrid, Spain.
Knee Surg Sports Traumatol Arthrosc. 2021 Jul;29(7):2024-2038. doi: 10.1007/s00167-020-05917-6. Epub 2020 Mar 16.
To synthesise the evidence on the prevalence of associated intraarticular lesions in subjects with acute acromioclavicular joint (ACJ) dislocations.
A search in two electronic databases (PUMBMED and EMBASE) was performed from 1985 to 2019. Two independent reviewers selected studies that complied with the following inclusion criteria: (1) the study included data on surgically treated ACJ dislocation grade III-V in the Rockwood classification, (2) the ACJ injuries were acute (the surgery was performed less than 6 weeks after injury), (3) an arthroscopic evaluation of the glenohumeral joint was performed during surgery. The quality of the studies included was assessed using the tool of the Joanna Briggs Institute.
A total of 47 studies with acute ACJ injuries met the initial inclusion criteria. Of these, 21 studies (9 retrospective case series, 9 prospective case series and 3 retrospective cohort studies) presented data on associated intraarticular lesions amenable for use in the meta-analysis. The meta-analysed studies included a total of 860 subjects with acute ACJ dislocations with a male/female ratio of 6.5 and a mean age of 32 years. The meta-analysis showed a prevalence of associated intraarticular lesions in subjects with acute ACJ of 19.9% (95% confidence interval [CI] 14.0-26.4%; 21 studies, 860 analysed participants; P = 0.000; I: 74.5% random-effects model; low risk of bias).
One in five subjects with surgically treated acute ACJ dislocations will have an associated intraarticular lesion that requires further intervention. The case for a customary arthroscopic evaluation of the joint, even when an open procedure is performed to deal with the ACJ dislocation, is strong. Level of evidence IV Trial registry Systematic review registration number: PROSPERO CRD42018090609.
综合急性肩锁关节（ACJ）脱位患者伴发关节内病变的患病率证据。
从 1985 年至 2019 年，在两个电子数据库（PUBMED 和 EMBASE）中进行了检索。两名独立的审查员选择符合以下纳入标准的研究：（1）研究包括 Rockwood 分类中 III-V 级手术治疗的 ACJ 脱位数据，（2）ACJ 损伤为急性（手术在损伤后 6 周内进行），（3）在手术过程中对盂肱关节进行关节镜评估。使用 Joanna Briggs 研究所的工具评估纳入研究的质量。
共有 47 项急性 ACJ 损伤研究符合初始纳入标准。其中，21 项研究（9 项回顾性病例系列研究、9 项前瞻性病例系列研究和 3 项回顾性队列研究）提供了可用于荟萃分析的伴发关节内病变数据。荟萃分析的研究共纳入 860 例急性 ACJ 脱位患者，男女比例为 6.5，平均年龄为 32 岁。荟萃分析显示，急性 ACJ 患者伴发关节内病变的患病率为 19.9%（95%置信区间 [CI] 14.0-26.4%；21 项研究，860 名分析参与者；P = 0.000；I：74.5%随机效应模型；低偏倚风险）。
在接受手术治疗的急性 ACJ 脱位患者中，每五分之一的患者会有需要进一步干预的伴发关节内病变。即使采用开放手术处理 ACJ 脱位，也强烈建议常规进行关节镜检查。证据等级 IV 试验注册系统评价注册号：PROSPERO CRD42018090609。
