Evidence map›Paper›PMID 35246100›Full record

SynthesisBMC musculoskeletal disorders2022

Does coracoclavicular augmentation additional to hook plate fixation provide benefits in acute unstable acromioclavicular dislocation? A meta-analysis.

Chih-Yao Lee, Po-Cheng Chen, Ying-Chun Liu, Yun-Che Tsai, Pei-Hsi Chou, Yin-Chih Fu, Wen-Chih Liu, Jesse Bernard Jupiter

Open access · goldAbstract readMeta-Analysis
In one paragraph

Synthesis in BMC musculoskeletal disorders, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
1.7field-weighted citation impact, top 16% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 11 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Review
  5. Review
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 2 countries.

Chih-Yao Lee *Department of Orthopedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 807, Kaohsiung, Taiwan.
Po-Cheng Chen *Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung, Taiwan.
Ying-Chun LiuSchool of Post-Baccalaureate Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Yun-Che TsaiDepartment of Orthopedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 807, Kaohsiung, Taiwan.
Pei-Hsi ChouDepartment of Orthopedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 807, Kaohsiung, Taiwan.
Yin-Chih FuDepartment of Orthopedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 807, Kaohsiung, Taiwan.
Wen-Chih LiuDepartment of Orthopedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, 807, Kaohsiung, Taiwan. andysirliu@gmail.com.
Jesse Bernard JupiterHand and Arm center, Department of Orthopedic surgery, Massachusetts General Hospital, Boston, MA, USA.
Kaohsiung Medical University Chung-Ho Memorial Hospital · TWKaohsiung Medical University · TWChang Gung University · TWKaohsiung Municipal Ta-Tung Hospital · TWMassachusetts General Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcromioclavicular joint (ACJ) dislocation is a common shoulder injury. In treating acute unstable ACJ dislocation, a hook plate (HP) is a straightforward and popular option for ensuring proper reduction and rigid fixation while promoting AC and coracoclavicular (CC) ligament healing. Surgeons typically remove the HP to prevent subacromial impingement and acromial osteolysis; however, concerns about redislocation after implant removal remain. Therefore, additional CC augmentation may be helpful in combination with HP fixation. The aim of this meta-analysis is to compare the outcomes and complications of HP fixation with or without additional CC augmentation for acute unstable ACJ dislocation.

methodsWe searched the PubMed, EMBASE, and Web of Science databases for relevant case-control studies. The primary outcomes were patient-reported outcome measures; the secondary outcomes were pain measured using a visual analog scale (VAS), CC distance (CCD), and complications. Continuous data were assessed using weighted standardized mean differences (SMDs) with 95% confidence intervals (CIs), and dichotomous data were evaluated with Mantel-Haenszel odds ratio (ORs) with 95% CIs.

resultsWe analyzed one randomized control trial and four case-control studies comparing HP fixation with or without CC augmentation. A total of 474 patients with Rockwood type III or V ACJ dislocation were included. We found no differences in Constant-Murley score (SMD, - 0.58, 95% CI - 1.41 to 0.26; P = 0.18), American Shoulder and Elbow Surgeons score (SMD, 0.21, 95% CI - 0.10 to 0.52; P = 0.19), University of California at Los Angeles shoulder rating scale score (SMD, - 0.02, 95% CI - 1.27 to 1.23; P = 0.97), or VAS pain score (SMD, 0.36, 95% CI - 0.16 to 0.88; P = 0.17) between groups. The CC augmentation group had lower odds of osteolysis (OR, 0.27, 95% CI 0.10 to 0.74; P = 0.01) and a shorter CCD (SMD, - 0.29, 95% CI - 0.57 to - 0.01; P = 0.04).

conclusionHP fixation with CC augmentation is preferable for acute unstable ACJ dislocations. Although CC augmentation did not provide additional benefits related to functional outcomes or pain, it resulted in greater reduction maintenance after implant removal and a 73% lower risk of acromial osteolysis.

trial registrationPROSPERO ( CRD42021271118 ).

Indexed as

Acromioclavicular JointJoint DislocationsShoulder DislocationBone PlatesHumansTreatment OutcomeAcromial osteolysisAcromioclavicular joint dislocationAcromioclavicular joint separationCoracoclavicular reconstructionCoracoclavicular repairHook plate

Identifiers

PMID35246100
PMCPMC8897880
OpenAlexW4214823116

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.