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Operative versus non-operative management following Rockwood grade III acromioclavicular separation: a meta-analysis of the current evidence base.

Smith, TO; Chester, R; Pearse, EO; Hing, CB (2011) Operative versus non-operative management following Rockwood grade III acromioclavicular separation: a meta-analysis of the current evidence base. J Orthop Traumatol, 12 (1). pp. 19-27. ISSN 1590-9999 https://doi.org/10.1007/s10195-011-0127-1
SGUL Authors: Hing, Caroline Blanca

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Abstract

BACKGROUND: Whilst there is little debate over the treatment of Rockwood grade V and VI acromioclavicular dislocation, the management of grade III acromioclavicular dislocation remains less clear. The purpose of this study was to compare the clinical outcomes of patients managed operatively and non-operatively following grade III acromioclavicular dislocation. MATERIALS AND METHODS: A systematic review of published and unpublished material was conducted. All included studies were reviewed against the PEDro appraisal tool. Where appropriate, a meta-analysis of pooled results was conducted. RESULTS: Among 724 citations, six studies met the eligibility criteria. All six studies were retrospective case series (level 4 evidence). The findings of this study indicated that operative management of grade III acromioclavicular dislocation results in a better cosmetic outcome (P < 0.0001) but greater duration of sick leave compared to non-operative management (P < 0.001). There was no difference in strength, pain, throwing ability and incidence of acromioclavicular joint osteoarthritis compared to non-operative management. Only one study recorded and showed a higher Constant score for operative management compared to non-operative management (P = 0.003). CONCLUSIONS: There is a lack of well-designed studies in the literature to justify the optimum mode of treatment of grade III acromioclavicular dislocations.

Item Type: Article
Additional Information: © The Author(s) 2011. Open Access This article is distributed under the terms of the Creative Commons Attribution 2.0 International License (https://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: Acromioclavicular Joint, Evidence-Based Medicine, Humans, Joint Dislocations, Physical Therapy Modalities, Trauma Severity Indices, Acromioclavicular Joint, Humans, Trauma Severity Indices, Evidence-Based Medicine, Physical Therapy Modalities, Joint Dislocations, Orthopedics
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: J Orthop Traumatol
ISSN: 1590-9999
Language: eng
Dates:
DateEvent
March 2011Published
23 February 2011Published Online
23 January 2011Accepted
Publisher License: Creative Commons: Attribution 2.0
PubMed ID: 21344264
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/113141
Publisher's version: https://doi.org/10.1007/s10195-011-0127-1

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