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Comparison of the outcome of early and delayed surgical treatment of complete acromioclavicular joint dislocation

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The aim of this study is to compare the clinical and radiographic results and the complication rate between early and delayed surgical treatment of acromioclavicular joint (ACJ) dislocation.

Methods

Publications in the management of ACJ dislocation are identified from the PubMed database between January 1993 and December 2013 using “acromioclavicular joint” and “dislocation” as keywords. The eligibility criteria included are as follows: (1) ACJ dislocation; (2) intervention, early compared with delayed surgical treatment or the surgical treatment for acute compared with chronic ACJ dislocation; (3) human; and (4) English articles. Exclusion criteria consist of the following: (1) type I and type II ACJ dislocation, (2) no definition of the time of early and delayed surgery in studies, (3) no comparison between the clinical result of early and delayed surgery in studies, (4) laboratory studies, radiographic studies, biomechanical studies, (5) the cases including fractures or revisions in studies, and (6) systematic analyses.

Results

Eight studies comparing early and delayed surgical treatment of ACJ dislocation are included in this systematic review. According to Constant scores and shoulder subjective value, early surgery has better functional outcomes than delayed surgery in the treatment of ACJ dislocation (P < 0.05). Partial-dislocation/re-dislocation is found at 26.0 % in early and 38.1 % in delayed surgical treatment (P < 0.05). The rate of CC ossification in early surgical treatment is found as the same as the delayed. The complication rates are found at 12.5 % in early surgical treatment and 17.7 % in the delayed, which is not significantly different.

Conclusion

Early surgical treatment may have superiority to the delayed procedure in the management of ACJ dislocation with better functional outcomes and more satisfied reduction. However, high-quality evidence studies are required to provide stronger support for this opinion in the future.

Level of evidence

IV.

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Acknowledgments

This study is supported by China Scholarship Council (CSC 2011658506). We would like to thank professor David Seligson, M.D., Department of Orthopaedic surgery, University of Louisville Hospital, Louisville, KY 40202, USA, for his English editing extensively.

Conflict of interest

No potential conflict of interest declared.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Shanghai Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China

    Tengfei Song & Tianwen Ye

  2. Department of Orthopaedic surgery, 455 Hospital of PLA, 338 West Huaihai Road, Shanghai, 200052, China

    Xu Yan

Authors
  1. Tengfei Song
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  2. Xu Yan
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Correspondence to Tianwen Ye.

Additional information

T. Song and X. Yan have contributed equally to this work.

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Song, T., Yan, X. & Ye, T. Comparison of the outcome of early and delayed surgical treatment of complete acromioclavicular joint dislocation. Knee Surg Sports Traumatol Arthrosc 24, 1943–1950 (2016). https://doi.org/10.1007/s00167-014-3225-9

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