Evidence map›Paper›PMID 37655239›Full record

ArticleOrthopaedic journal of sports medicine2023

Prospective Multicenter Randomized Controlled Trial of Surgical Versus Nonsurgical Treatment for Acute Rockwood Type 3 Acromioclavicular Injury.

Mark Tauber, Thomas Hoffelner, Lars Lehmann, Natascha Kraus, Markus Scheibel, Philipp Moroder

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Orthopaedic journal of sports medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

19 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  19. 3D C-arm navigated suture button implantation for AC joint dislocations - the pilot study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024
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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

6 authors.

Mark TauberGerman Shoulder Center, ATOS Clinic, Munich, Germany.
Thomas HoffelnerDepartment of Orthopaedic and Trauma Surgery, Paracelsus Medical University, Salzburg, Austria.
Lars LehmannDepartment of Orthopaedics and Traumatology, St Vinzenz Kliniken, Karlsruhe, Germany.
Natascha KrausDepartment of Shoulder and Elbow Surgery, Center for Musculoskeletal Surgery, Charitè University Hospital, Berlin, Germany.
Markus ScheibelDepartment of Shoulder and Elbow Surgery, Center for Musculoskeletal Surgery, Charitè University Hospital, Berlin, Germany.
Philipp MoroderDepartment of Shoulder and Elbow Surgery, Center for Musculoskeletal Surgery, Charitè University Hospital, Berlin, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Evidence for the superiority of surgical versus nonsurgical treatment of Rockwood type 3 acromioclavicular joint (ACJ) dislocation is still lacking. Hypothesis: It was hypothesized that surgical treatment will outperform nonsurgical treatment. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: A prospective randomized trial involving 4 study centers was performed from January 1, 2011, to March 31, 2016. A total of 85 patients with acute Rockwood type 3 ACJ dislocations were allocated randomly to receive either nonsurgical or surgical treatment. A total of 70 patients were treated as allocated, and 8 patients made an early crossover from nonsurgical to surgical treatment, leaving 47 patients treated surgically and 31 patients nonsurgically. All patients were followed up longitudinally, including clinical evaluation using the Constant score and standardized radiographic evaluation, with final follow-up after 2 years. Results: At no follow-up time point was there a significant difference in Constant score between the surgically and nonsurgically treated patients. Radiographic analysis showed not only an inferior coracoclavicular distance at all follow-up points for surgical treatment but also a higher incidence of posttraumatic osteoarthritis and heterotopic ossifications, without any negative clinical correlation. With regard to complications, 1 patient (3%) in the nonsurgical group underwent secondary surgical ACJ stabilization. The revision rate after surgical treatment was 17% ( Conclusion: Surgical treatment of ACJ Rockwood type 3 injuries did not lead to superior functional outcomes. Neither younger age nor horizontal instability were associated with inferior outcomes after nonsurgical treatment. Surgical treatment led to a slower recovery and to higher complication and revision rates. Registration: ISRCTN registry (study ID: ISRCTN92265154).

Indexed as

acromioclavicular dislocationfunctional outcomeRockwood type 3skillful neglectsurgery

Identifiers

PMID37655239
PMCPMC10467399

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Registered trials

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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.