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No Differences in Outcomes Between Operative and Non-Operative Approaches for High-Grade Acromioclavicular Joint
Noppanat Poovarodom1, Natabhorn Kashemsri Na Ayudhaya1, Thanong Sanitwaja1
1Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Background:
This study aimed to compare the clinical outcomes and complications of operative versus non-operative approaches in treating patients with high-grade acromioclavicular (AC) joint injuries.
Methods:
A search was conducted in PubMed, Scopus, and Cochrane databases for studies published between 2007 and 2024. The search focused on studies directly comparing postoperative patient-reported outcomes, radiographic findings, and complications associated with surgical and non-surgical techniques for high-grade AC joint injuries. For dichotomous outcomes, odds ratios (ORs) were calculated, while mean differences (MDs) were computed for continuous outcomes.
Results:
A total of eight studies, encompassing 473 AC joints, were analyzed. The results indicated no statistically significant differences in postoperative clinical outcomes at final follow-up between the operative and non-operative approaches. Specifically, among the seven studies reporting the Constant Score, MD was - 1.38 (95% confidence interval [CI] - 3.14 to 0.38, p = 0.12). For the Disabilities of the Arm, Shoulder, and Hand score, the MD was 1.92 (95% CI - 0.34 to 4.17, p = 0.10), indicating no statistically significant differences. Additional radiographic findings also suggested similar outcomes between the two treatment modalities.
Conclusion:
The analysis revealed comparable clinical outcomes between the two approaches, demonstrating that both strategies can be considered viable options for patient management.
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