Abstract :

Introduction: Surgical treatment is usually recommended for acute, high grade acromio- clavicular joint injuries. A wide variety of surgical techniques exist and the literature does not strongly support one over the other. In this systematic review we com-pared the results of dierent surgical treatments for the management of acute unstable acromioclavicular joint dislocation and aim to guide surgeons on optimal treatment.Materials and Methods: A systematic review of the literature was performed searching the PubMed, Medline, Cochrane and Embase databases.18 studies met the inclusion criteria and were analysed. Only studies with comparative data were includ-ed. Clinical and radiological outcomes of these studies were reviewed.Results: Review of the literature found no dierence in outcomes between open and arthroscopic procedures. Coracoclavicu-lar ligament reconstruction techniques tend to provide better results than the more rigid hook plate fixation. There is no evi-dence that biologic repair with tendon graft is superior to synthetic grafts. Furthermore autograft is not shown to be better than allograft. Rigid fixation between the clavicle and coracoid, and the non-anatomic Weaver-Dunn technique appear to be less popular in the recent literature. Hook plate is associated with subacromial osteolysis, acromial erosion and the morbidity of a secondary procedure.Conclusion: Despite a significant recent increase in publications on reconstruction of the acromioclavicular joint after injury, there is a lack of high quality comparative evidence.Meaningful comparisons are dicult to draw due to the heterogeneity of the treatments used and the outcome measured used to assess the results.

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