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Acromioclavicular Dislocation: Conservative or Surgical Therapy.

Jennifer M. Hootman1

  • 1Centers for Disease Control and Prevention, Atlanta, GA.

Journal of Athletic Training
|April 16, 2004
PubMed
Summary

For acromioclavicular (AC) dislocations, conservative treatment offers similar or better outcomes than surgery. Surgical intervention for AC dislocations leads to longer recovery times and higher complication rates.

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Area of Science:

  • Orthopedics
  • Sports Medicine
  • Traumatology

Background:

  • Acromioclavicular (AC) joint dislocations are common injuries, particularly among athletes.
  • Treatment decisions for severe AC dislocations (grade III) often involve a choice between conservative management and surgical intervention.
  • Optimal treatment strategy remains debated, impacting patient recovery and long-term joint function.

Purpose of the Study:

  • To compare the clinical outcomes of surgical versus conservative therapy for patients with acromioclavicular dislocations.
  • To evaluate differences in patient satisfaction, return to work/activity, complications, and functional recovery between treatment groups.

Main Methods:

  • A systematic review of English-language studies published between 1966 and 1997 was conducted.
  • Included studies focused on grade III AC dislocations with significant displacement.
  • Data were extracted on outcomes such as overall satisfaction, return to work, complications, pain, range of motion, and strength.

Main Results:

  • Both surgical and conservative treatments yielded high overall satisfactory outcomes (88% vs. 87%).
  • Surgical treatment was associated with longer return-to-work and premorbid activity times.
  • Higher rates of reoperation (59% vs. 6%), fixation failure (20%), and wound complications were observed in the surgical group.

Conclusions:

  • Current evidence does not support routine surgical treatment for grade III AC dislocations.
  • Conservative management appears to provide comparable or superior outcomes regarding patient satisfaction and functional recovery.
  • Surgical intervention for AC dislocations carries a higher risk of complications and prolonged recovery.

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