Abstract
PurposeAcromioclavicular (AC) joint dislocations are common in a young and active population, especially in people performing contact sports. Full recovery with a fast and high rate of return to sport is desirable. This systematic review aims to combine patient outcomes in order to help surgeons in addressing patient expectations regarding the return to sport after surgical intervention for AC dislocations.MethodsTo conduct this systematic review, the PRISMA guidelines were followed. Articles were included if written in English or Dutch and evaluated return to sport after any type of surgical intervention for Rockwood types III to VI AC dislocations in patients practicing sports. Outcome parameters were return to sport, time to return to sport, level of sport, functional outcome scores and complications.ResultsTwelve studies involving 498 patients were included, of which 462 patients practiced sports. 432 (94%) patients returned to sport. The weighted mean time to return to sport was 4.0 months. 338 out of 401 patients (84%) returned to the same level of pre-injury sport and 35 patients (9%) lowered their level of sport. The weighted mean Constant score was 92 out of 100.ConclusionThe rate of return to sport after surgical intervention for Rockwood (RW) III–VI AC dislocations is high. However, the level of evidence was low and due to the methodological heterogeneity between studies, subgroup analyses of return to sport outcomes were not feasible.Level of evidenceSystematic review of level I–IV studies, level IV.
Highlights
Acromioclavicular (AC) joint injuries are common in young athletes with an incidence of 9.2 per 1000 person-years [27]
For type IV to VI AC joint dislocations, surgical treatment generally is the intervention of choice [21, 29, 31]
A trend is set toward initial non-surgical treatment, unless non-surgical treatment fails in patients with persistent pain or the inability to return to sport or work [21, 29, 31]
Summary
Acromioclavicular (AC) joint injuries are common in young athletes with an incidence of 9.2 per 1000 person-years [27]. The incidence of AC injuries is higher in contact sports and is highest in adults in their 20s [21, 31]. Full recovery with return to pre-injury level of sports and minimal time lost to injury is essential in the treatment of these injuries. Most type I and II dislocations are treated conservatively. For type IV to VI AC joint dislocations, surgical treatment generally is the intervention of choice [21, 29, 31]. The optimal management of type III AC joint dislocations remains controversial. A trend is set toward initial non-surgical treatment, unless non-surgical treatment fails in patients with persistent pain or the inability to return to sport or work [21, 29, 31]
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