ReviewOrthopaedic journal of sports medicine2026
Outcomes After Operative Versus Nonoperative Management of Type III to V Acromioclavicular Joint Dislocations: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
Review in Orthopaedic journal of sports medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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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.
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Authors and funding
8 authors.
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Abstract
Background: Acromioclavicular joint (ACJ) injuries are common; however, there is disagreement about the optimal treatment of Rockwood type ≥III ACJ dislocations. Purpose: To systematically review and meta-analyze the outcomes of all randomized controlled trials that compared the operative and nonoperative treatment of Rockwood type III to V ACJ dislocations. Study Design: Systematic review; Level of evidence, 2. Methods: A systematic search of 4 databases was performed through September 15, 2024. Inclusion criteria included (1) adult patients, (2) acute Rockwood type III to V ACJ dislocations, (3) direct comparisons of operative to nonoperative management, (4) randomized controlled trial methodology, and (5) reporting of clinical outcomes. The primary outcome was the Constant score, and secondary outcomes consisted of other patient-reported outcome measure (PROM) scores, cosmesis, radiographic findings, range of motion, return to work/sport, complications, and unplanned surgery. Results: There were 5 comparative studies included in this review with a total of 367 patients: 193 patients underwent operative treatment (102 type III, 11 type IV, 40 type V, and 40 type III-V), and 174 underwent nonoperative treatment (84 type III, 13 type IV, 34 type V, and 43 type III-V). The mean age was 39.1 years for operative patients and 37.4 years for nonoperative patients. The follow-up ranged from 12 to 229.2 months. The mean Constant score at ≥2 years was 92.4 for operative patients and 90.1 for nonoperative patients, with meta-analysis demonstrating no significant differences at ≥2 years (95% CI, -0.03 to 0.43; Conclusion: There were comparable PROM scores at ≥1 year when comparing operative to nonoperative treatment in patients who sustained a Rockwood type III to V ACJ dislocation. However, early PROM scores favored nonoperative management. There were comparable satisfaction rates and comparable return to work/sport rates between groups. Therefore, the nonoperative management of type III to V ACJ dislocations resulted in comparable clinical outcomes compared to operative treatment.
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