SynthesisMedicine2018
Comparison of surgical and conservative treatment of Rockwood type-III acromioclavicular dislocation: A meta-analysis.
Synthesis in Medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
35 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Comparative efficacy of operative versus conservative treatment for Rockwood type III acromioclavicular joint dislocation: a systematic review and meta-analysis of randomized controlled trials.BMC musculoskeletal disorders · 2024Pooled it
- Return to sport after surgical treatment for high-grade (Rockwood III-VI) acromioclavicular dislocation.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2019Pooled it
- Comparative evaluation of hook plate and tension band wiring in the management of acromioclavicular dislocation: a retrospective study.Annals of medicine and surgery (2012) · 2026Article
- Comprehensive review of acromioclavicular joint dislocation: anatomy, mechanism, imaging, treatment and rehabilitation-narrative review.Journal of orthopaedic surgery and research · 2026Review
- No Differences in Outcomes Between Operative and Non-Operative Approaches for High-Grade Acromioclavicular Joint Injuries: A Systematic Review and Meta-analysis.Indian journal of orthopaedics · 2026Review
- Orthogonal soft tissue reconstruction for acute acromioclavicular joint dislocations: 'A novel technique ensures predictable outcomeJournal of clinical orthopaedics and trauma · 2025Article
- Comparison of endobutton and tendon graft techniques in acromioclavicular joint dislocation: Early treatment yields better outcomes.Medicine · 2025Article
- Clinical and radiographic outcomes following anatomic coracoclavicular ligament reconstruction using 4-strand taped suspensory fixation in an active-duty military population.JSES international · 2025Article
- Surgical vs conservative: what is the best treatment of acute Rockwood III acromioclavicular joint dislocation? A systematic review and meta-analysis.EFORT open reviews · 2025Article
- Review
- Acromioclavicular joint dislocation with loop double endobutton fixation assisted by orthopaedic surgery robot positioning system.BMC musculoskeletal disorders · 2024Article
- Medial placement of trapezoid tunnel leads to higher reduction loss in acute acromioclavicular joint dislocation treated with anatomic coracoclavicular fixation.Shoulder & elbow · 2024Article
- The Effect of Clavicular Tunnel Position on Reduction Loss in Patients with Acute Acromioclavicular Joint Dislocations Operated with a Single-Bundle Suspensory Loop Device.Orthopaedic surgery · 2024Article
- Double figure of eight technique using fiber tape for acute high-grade acromioclavicular joint dislocations - Reconstruction technique.Journal of clinical orthopaedics and trauma · 2024Review
- Current Concepts in Management of Acromioclavicular Joint Injury.Journal of clinical medicine · 2024Review
- Prospective Multicenter Randomized Controlled Trial of Surgical Versus Nonsurgical Treatment for Acute Rockwood Type 3 Acromioclavicular Injury.Orthopaedic journal of sports medicine · 2023Article
- Conservative treatment of Rockwood type III acromioclavicular joint separation: a randomized controlled trial sling vs. brace.JSES international · 2023Article
- Anatomic coracoclavicular ligament reconstruction with triple flip-buttons leads to good functional outcomes and low reduction loss: a case series.Clinics in shoulder and elbow · 2023Article
- The Reliability of Acromioclavicular Joint Dislocation Classification Systems: A Comparison Between the Rockwood and Kraus Classifications.Orthopaedic journal of sports medicine · 2023Article
- Management of Acromioclavicular Injuries - Current Concepts.Orthopedic research and reviews · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere is no consensus on the effects of surgical versus conservative treatment on Rockwood type-III dislocation of the acromioclavicular joint in general orthopedic practice. The objective of this meta-analysis was to compare the clinical outcomes of patients managed surgically and conservatively following type-III acromioclavicular (AC) dislocation.
methodsThe Cochrane Library, EMBASE, MEDLINE via Ovid SP, and PubMed databases were searched for randomized controlled trials and observational studies. Patient data were pooled using standard meta-analytic approaches. For continuous variables, the weighted mean difference was used. For dichotomous data, the odds ratio was calculated.
resultsThe current analysis included 10 trials on this topic, and the results demonstrated that there were no significant differences between surgical and conservative treatment in terms of pain, weakness, tenderness, post-traumatic arthritis, restriction of strength, unsatisfactory function, and scores (Constant, UCLA, Imatani, SST, DASH, Larsen). Analyses of ossification of the coracoclavicular ligament (OR = 1.62, 95% CI = 1.01-2.61) and osteolysis of the lateral clavicle (OR = 2.87, 95% CI = 1.27-6.52) suggested better function with conservative treatment versus surgical treatment, but the latter was superior to conservative treatment with regard to loss of anatomic reduction. Only 1 study showed a higher acromioclavicular joint instability score for surgical management compared with conservative management (P < .00001).
conclusionIn the management of Rockwood type-III AC dislocation, conservative treatment is superior to surgical treatment. Nonoperative treatment results in a lower incidence of ossification of the coracoclavicular ligament and osteolysis of the lateral clavicle compared with operative treatment. However, there was no statistical difference between operative and nonoperative treatment in terms of clinical outcomes.
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