Orthopaedics Institute, Fondazione Policilinico A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy.
University of Brescia, Brescia, Italy.
Knee Surg Sports Traumatol Arthrosc. 2021 Jul;29(7):2175-2193. doi: 10.1007/s00167-020-06217-9. Epub 2020 Aug 14.
To systematically review the outcomes of surgical treatments of acute acromioclavicular joint dislocation.
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.
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.
Biological and synthetic reconstructions achieved better functional scores compared to osteosynthesis. Among suture buttons, the triple button showed better functional performance.
IV.
系统回顾急性肩锁关节脱位的手术治疗结果。
通过电子数据库（Ovid、PubMed）进行研究检索。纳入所有报告急性肩锁关节脱位手术治疗的功能和影像学结果的研究。提取的数据包括：作者和年份、研究设计、证据水平、患者人数、年龄、肩锁关节脱位分类、手术时间、手术技术、随访、临床和影像学结果、并发症和失败。当无法进行数据汇总时，使用描述性统计。将可比较的结果汇总，生成以频率加权值报告的综合结果。通过 MINORS 清单进行质量评估。
共纳入 133 项研究，总计 4473 例肩关节。参与者的平均年龄为 36.9 岁。平均随访时间为 42.06 个月。与开放式手术相比，关节镜显示出更好的 ASES（p<0.0001）和更低的 VAS 疼痛评分（p=0.0249）。生物和合成重建技术的结果优于骨内固定技术。生物技术在整体上显示出更好的 Constant（p=0.0001）和 DASH（p=0.0215）评分，而合成重建显示出更好的 UCLA 评分（p=0.0001）。在缝线纽扣中，三排纽扣在 Constant（p=0.0001）和 VAS（p=0.0001）评分方面总体上显示出更好的结果，而两种双排纽扣技术在 DASH 评分方面（p=0.0003）取得了更好的结果。总体而言，证据水平较低。
生物和合成重建技术比骨内固定技术获得更好的功能评分。在缝线纽扣中，三排纽扣显示出更好的功能表现。
IV。
