Surgical treatments for acute unstable acromioclavicular joint dislocations
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Authors
Saraglis, Georgios
Issue Date
2022-09-07
Type
Scientific Paper
Language
Keywords
Acromioclavicular joint dislocation , Acromioclavicular joint reconstruction , Hook plate fixation , Coracoclavicular ligament reconstruction
Alternative Title
Abstract
Abstract – 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.
Description
Citation
Saraglis, G. et al. (2022) “Surgical treatments for acute unstable acromioclavicular joint dislocations,” SICOT-J, 8, p. 38. Available at: https://doi.org/10.1051/sicotj/2022038.