Is there a role for acromioclavicular (AC) joint capsular repair and reconstruction in high-grade AC separations? A systematic review
Purpose: To evaluate the clinical and biomechanical evidence for the addition of acromioclavicular (AC) ligament repair and reconstruction in the surgical management of high-grade AC joint (ACJ) dislocation. Methods: This is a systematic review of biomechanical and clinical studies that describe AC...
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Bioscientifica
2025-02-01
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| Series: | EFORT Open Reviews |
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| Online Access: | https://eor.bioscientifica.com/view/journals/eor/10/2/EOR-2023-0121.xml |
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| author | Al-Achraf Khoriati Tony Antonios Zien Alabdin Fozo Aliya Choudhury Magnus Arnander Eyiyemi Pearse Duncan Tennent |
| author_facet | Al-Achraf Khoriati Tony Antonios Zien Alabdin Fozo Aliya Choudhury Magnus Arnander Eyiyemi Pearse Duncan Tennent |
| author_sort | Al-Achraf Khoriati |
| collection | DOAJ |
| description | Purpose: To evaluate the clinical and biomechanical evidence for the addition of acromioclavicular (AC) ligament repair and reconstruction in the surgical management of high-grade AC joint (ACJ) dislocation. Methods: This is a systematic review of biomechanical and clinical studies that describe AC reconstructive or reparative techniques. The search ranged from 1946 to 2024 and included OVID, MEDLINE, PubMed, CINAHL, Embase, Google Scholar and the Cochrane Library databases. Clinical and biomechanical outcomes were evaluated. Results: Thirty-two eligible studies were identified. Of these, four biomechanical studies focused on the ACJ exclusively. Twenty-eight other studies (15 clinical and 13 biomechanical) were identified involving reconstruction of the ACJ in addition to the treatment of the coracoclavicular (CC) ligaments. There was clinical evidence of improved outcomes with ACJ repair and reconstruction, although comparison was difficult. In comparative studies, ACJ-specific Taft and acromioclavicular joint instability scores were improved in patients with ACJ reconstruction. Constant score and subjective shoulder value also increased, although this was observed in studies lacking a control group. The biomechanical studies provide evidence of increased translational and rotational stability with ACJ repair and reconstruction, but the optimal technique has not been identified. Conclusion: ACJ repair and reconstruction, in addition to CC repair, results in improved biomechanical and functional outcomes and should be considered when treating high-grade ACJ injuries. There is insufficient evidence in the literature to be able to recommend a specific technique to treat ACJ injuries. |
| format | Article |
| id | doaj-art-808a61512bd2412b9d39a45fec7a8ccc |
| institution | Kabale University |
| issn | 2058-5241 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Bioscientifica |
| record_format | Article |
| series | EFORT Open Reviews |
| spelling | doaj-art-808a61512bd2412b9d39a45fec7a8ccc2025-02-09T12:01:22ZengBioscientificaEFORT Open Reviews2058-52412025-02-0110211512410.1530/EOR-2023-01211Is there a role for acromioclavicular (AC) joint capsular repair and reconstruction in high-grade AC separations? A systematic reviewAl-Achraf Khoriati0Tony Antonios1Zien Alabdin Fozo2Aliya Choudhury3Magnus Arnander4Eyiyemi Pearse5Duncan Tennent6St Georges Hospital, London, UKSt Georges Hospital, London, UKAshford and St Peter's Hospital, Chertsey, UKSt Georges Hospital, London, UKSt Georges Hospital, London, UKSt Georges Hospital, London, UKSt Georges Hospital, London, UKPurpose: To evaluate the clinical and biomechanical evidence for the addition of acromioclavicular (AC) ligament repair and reconstruction in the surgical management of high-grade AC joint (ACJ) dislocation. Methods: This is a systematic review of biomechanical and clinical studies that describe AC reconstructive or reparative techniques. The search ranged from 1946 to 2024 and included OVID, MEDLINE, PubMed, CINAHL, Embase, Google Scholar and the Cochrane Library databases. Clinical and biomechanical outcomes were evaluated. Results: Thirty-two eligible studies were identified. Of these, four biomechanical studies focused on the ACJ exclusively. Twenty-eight other studies (15 clinical and 13 biomechanical) were identified involving reconstruction of the ACJ in addition to the treatment of the coracoclavicular (CC) ligaments. There was clinical evidence of improved outcomes with ACJ repair and reconstruction, although comparison was difficult. In comparative studies, ACJ-specific Taft and acromioclavicular joint instability scores were improved in patients with ACJ reconstruction. Constant score and subjective shoulder value also increased, although this was observed in studies lacking a control group. The biomechanical studies provide evidence of increased translational and rotational stability with ACJ repair and reconstruction, but the optimal technique has not been identified. Conclusion: ACJ repair and reconstruction, in addition to CC repair, results in improved biomechanical and functional outcomes and should be considered when treating high-grade ACJ injuries. There is insufficient evidence in the literature to be able to recommend a specific technique to treat ACJ injuries.https://eor.bioscientifica.com/view/journals/eor/10/2/EOR-2023-0121.xmlacromioclavicular jointcapsular repairreconstruction |
| spellingShingle | Al-Achraf Khoriati Tony Antonios Zien Alabdin Fozo Aliya Choudhury Magnus Arnander Eyiyemi Pearse Duncan Tennent Is there a role for acromioclavicular (AC) joint capsular repair and reconstruction in high-grade AC separations? A systematic review EFORT Open Reviews acromioclavicular joint capsular repair reconstruction |
| title | Is there a role for acromioclavicular (AC) joint capsular repair and reconstruction in high-grade AC separations? A systematic review |
| title_full | Is there a role for acromioclavicular (AC) joint capsular repair and reconstruction in high-grade AC separations? A systematic review |
| title_fullStr | Is there a role for acromioclavicular (AC) joint capsular repair and reconstruction in high-grade AC separations? A systematic review |
| title_full_unstemmed | Is there a role for acromioclavicular (AC) joint capsular repair and reconstruction in high-grade AC separations? A systematic review |
| title_short | Is there a role for acromioclavicular (AC) joint capsular repair and reconstruction in high-grade AC separations? A systematic review |
| title_sort | is there a role for acromioclavicular ac joint capsular repair and reconstruction in high grade ac separations a systematic review |
| topic | acromioclavicular joint capsular repair reconstruction |
| url | https://eor.bioscientifica.com/view/journals/eor/10/2/EOR-2023-0121.xml |
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