Acute Rockwood type III ACJ dislocation: Conservative vs surgical approach. A systematic review and meta-analysis of current concepts in literature

Via, Riccardo Giai; Bosco, Francesco; Giustra, Fortunato; Lavia, Alessandro Dario; Artiaco, Stefano; Risitano, Salvatore; Giachino, Matteo; Massè, Alessandro

doi:10.1016/j.injury.2022.07.050

Cited by 12 publications

(8 citation statements)

References 23 publications

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“…This systematic review of the literature was performed in accordance with the Preferred Reporting Items for systematic reviews and meta-analyses (PRISMA) guidelines [20,[24][25][26]. The literature search was conducted by three independent reviewers (G.C., F.B., and F.G.) to search for comparative gait analyses of MP vs. PS TKA studies.…”

Section: Methodsmentioning

confidence: 99%

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Comparison between gaits after a medial pivot and posterior stabilized primary total knee arthroplasty: a systematic review of the literature

et al. 2023

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Background Total knee arthroplasty (TKA) is one of the most performed orthopedic procedures worldwide. While excellent efficacy has been reported, about 20% of patients are not satisfied with the result. A potential cause is the problematic reproduction of knee kinematics. This systematic review examines gait analysis studies in primary medial pivot (MP) and posterior stabilized (PS) TKAs to investigate the differences between the two prosthesis designs. Methods A systematic review was conducted by following PRISMA guidelines. Five databases (PubMed, Medline, Embase, Scopus and the Cochrane Database of Systematic Reviews) were analyzed, and eligible articles were evaluated in terms of the levels of evidence. The methodological quality of the articles was assessed by using the MINORS scoring. This review was registered in PROSPERO. Results Nine studies were included. Gait analysis was performed in 197 MP TKA and 192 PS TKA patients. PS TKA cases showed (P < 0.05) a significantly higher peak of knee flexion angle during the swing phase, greater knee flexion angle at toe-off, an increased knee adduction angle, higher knee flexion and extension moment, increased anterior femoral roll during knee flexion and anterior translation on medial and lateral condyle during knee flexion compared to MP TKA. MP TKA showed statistically significant (P < 0.05) higher knee rotational moment and greater tibiofemoral external rotation motion during knee flexion than PS TKA. No statistically significant difference (P > 0.05) was reported regarding gait spatial–temporal parameters. The Forgotten Joint Score (FJS) and Western Ontario and McMaster Universities Comparison in terms of Arthritis Index (WOMAC) score (mean stiffness) showed that MP TKA yielded significantly better results than PS TKA. Conclusions This systematic review revealed significant kinematic and kinetic differences between MP and PS TKA at all gait analysis phases. Furthermore, the considerable difference between TKA design and the kinematics of healthy knee were highlighted in this study. Level of evidence III.

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Section: Methodsmentioning

confidence: 99%

“…Gait analysis was performed in 197 MP TKA (average age, 69.4 ± 3.9 years) and in 192 PS TKA patients (average age, 68.6 ± 4.4). Three studies [23,26,27] performed gait analysis also in a control group involving 40 healthy knees (average age, 36.1 ± 5.7). The average study quality based on MINORS criteria was 14.6 ± 2.6.…”

Section: Study Characteristicsmentioning

confidence: 99%

Comparison between gaits after a medial pivot and posterior stabilized primary total knee arthroplasty: a systematic review of the literature

et al. 2023

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“…Articles in English, German, Italian, French, and Spanish, according to the authors language capabilities, were considered. Studies with level I–III of evidence, according to the Oxford Centre of Evidence-Based Medicine [ 32 – 34 ], were eligible. Studies that performed ACL reconstruction/repair in a multiple ligament damage setting were not eligible.…”

Section: Methodsmentioning

confidence: 99%

Reduced knee laxity and failure rate following anterior cruciate ligament reconstruction compared with repair for acute tears: a meta-analysis

et al. 2023

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Background Following anterior cruciate ligament (ACL) tears, both repair and reconstruction may be performed to restore joint biomechanics and proprioception. The present study compared joint laxity, patient-reported outcome measures (PROMs), and rate of failure following primary repair versus reconstruction for ACL ruptures. Methods This meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Pubmed, Google scholar, Embase, and Web of Science were accessed in September 2022. All the clinical investigations comparing repair versus reconstruction for primary ACL tears were accessed. Studies reporting data on multiple ligament injuries settings were not eligible. Results Data from eight articles (708 procedures) were collected. The mean length of the follow-up was 67.3 ± 119.4 months. The mean age of the patients was 27.1 ± 5.7 years. Thirty-six percent (255 of 708 patients) were women. The mean body mass index (BMI) was 24.3 ± 1.1 kg/m2. The mean time span from injury to surgery was 36.2 ± 32.3 months. There was comparability at baseline with regards to instrumental laxity, Lachman test, International Knee Document Committee (IKDC), and Tegner Scale (P > 0.1). Similarity between ACL reconstruction and repair was found in IKDC (P = 0.2) and visual analog scale (VAS) satisfaction (P = 0.7). The repair group demonstrated greater mean laxity (P = 0.0005) and greater rate of failure (P = 0.004). Conclusion ACL reconstruction may yield greater joint stability and lower rate of failure compared with surgical repair. Similarity was found in PROMs. Level of evidence: III

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“…3,4 As a result, nonsurgical treatment of acute Rockwood type III ACJ dislocation may result in high rates of pain and shoulder dysfunction. 5,6 Therefore, surgery is recommended for acute Rockwood type III ACJ dislocation, especially in young active patients. 7 The surgical techniques used to treat acute Rockwood type III ACJ dislocation include temporary K-wire transfixation, CC screw fixation, hook plate fixation, and Endobutton placement.…”

Section: Introductionmentioning

confidence: 99%

“…In acute Rockwood type III ACJ dislocation, the coracoclavicular (CC) ligament is completely torn; this disruption of the CC ligament leads to vertical instability because of the downward pull of the weight of the arm and the superior pull of the trapezius muscle 3,4 . As a result, nonsurgical treatment of acute Rockwood type III ACJ dislocation may result in high rates of pain and shoulder dysfunction 5,6 . Therefore, surgery is recommended for acute Rockwood type III ACJ dislocation, especially in young active patients 7 …”

Section: Introductionmentioning

confidence: 99%

A Self‐Designed Endobutton Installation Device for Coracoclavicular Stabilization in Acute Rockwood Type III Acromioclavicular Joint Dislocation

Jie,

Yang,

Xiang

2024

Orthopaedic Surgery

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ObjectiveEndobutton technique could provide flexible coracoclavicular (CC) stabilization for acromioclavicular joint (ACJ) dislocation and achieved good clinical outcomes. However, the difficult part of this technique was placement of the Endobutton to the coracoid base. In this study, we designed an Endobutton installation device to place the Endobutton at the coracoid base. And we examined the clinical and radiographic outcomes of patients with acute Rockwood type III ACJ dislocation repaired with Endobutton using this device.MethodsWe designed an Endobutton installation device to place the Endobutton at the coracoid base to achieve CC stabilization. We retrospectively reviewed 42 patients with acute Rockwood type III ACJ dislocation who underwent CC stabilization with Endobuttons placed either using this novel device (group I, n = 19) or the traditional technique (CC stabilization without using special device, group II, n = 23) from January 2015 to April 2020. The two groups were compared regarding the operative time, intraoperative blood loss, and clinical and radiologic outcomes at final follow‐up. The operation‐related complications were also evaluated. The Student's t test and the Mann–Whitney U‐test were used to compare differences in continuous variables. Differences in categorical variables were assessed with either the Pearson's chi‐squared test or Fisher's exact test.ResultsForty‐two patients were clinically followed up for a minimum of 12 months. Compared with group II, group I had a significantly shorter mean operative time (56.05 ± 7.82 min vs. 65.87 ± 7.43 min, p < 0.01) and significantly lesser mean intraoperative blood loss (67.89 ± 14.75 mL vs. 94.78 ± 25.01 mL, p < 0.01). At final follow‐up, there were no significant differences between the two groups in the visual analog scale score for pain, Oxford Shoulder Score, Disabilities of the Arm, Shoulder, and Hand score, and postoperative CC distance of the affected side. Loss of reduction occurred in four patients in group I and three patients in group II (p = 0.68); there were no other operation‐related complications in either group.ConclusionsThe Endobutton installation device makes placement of the Endobutton at the coracoid base easier and achieves satisfactory clinical and radiologic outcomes without additional complications in acute Rockwood type III ACJ dislocation.

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Acute Rockwood type III ACJ dislocation: Conservative vs surgical approach. A systematic review and meta-analysis of current concepts in literature

Cited by 12 publications

References 23 publications

Comparison between gaits after a medial pivot and posterior stabilized primary total knee arthroplasty: a systematic review of the literature

Comparison between gaits after a medial pivot and posterior stabilized primary total knee arthroplasty: a systematic review of the literature

Reduced knee laxity and failure rate following anterior cruciate ligament reconstruction compared with repair for acute tears: a meta-analysis

A Self‐Designed Endobutton Installation Device for Coracoclavicular Stabilization in Acute Rockwood Type III Acromioclavicular Joint Dislocation

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