Please use this identifier to cite or link to this item: https://hdl.handle.net/1822/67404

TitleAnatomic and non-anatomic reconstruction improves post-operative outcomes in chronic acromio-clavicular instability: a systematic review
Author(s)Xará-Leite, Francisco
Andrade, Renato
Moreira, Pedro Silva
Coutinho, Luís
Ayeni, Olufemi R.
Sevivas, Nuno
Espregueira-Mendes, João
KeywordsAcromioclavicular Joint
Humans
Joint Instability
Orthopedic Procedures
Patient Satisfaction
Range of Motion, Articular
Reoperation
Return to Work
Visual Analog Scale
Non-anatomic reconstruction
Acromio-clavicular
Chronic instability
Anatomic reconstruction
Issue dateDec-2019
PublisherSpringer
JournalKnee Surgery, Sports Traumatology, Arthroscopy (KSSTA)
CitationXará-Leite, F., Andrade, R., Moreira, P. S., Coutinho, L., Ayeni, O. R., et. al. (2019). Anatomic and non-anatomic reconstruction improves post-operative outcomes in chronic acromio-clavicular instability: a systematic review. Knee Surgery, Sports Traumatology, Arthroscopy, 27(12), 3779-3796
Abstract(s)To systematize the surgical outcomes of anatomic and non-anatomic reconstruction in patients with chronic acromio-clavicular joint (ACJ) instability and determine which technique is superior. Purpose To systematize the surgical outcomes of anatomic and non-anatomic reconstruction in patients with chronic acromio-clavicular joint (ACJ) instability and determine which technique is superior. Methods This review was conducted according to the PRISMA guidelines. PubMed and Cochrane Library databases were searched up to April 30th, 2018 for original articles that assessed the outcomes of one or more surgical techniques of anatomic and non-anatomic reconstruction in patients with chronic ACJ instability. The Methodological Index for Non-randomized Studies (MINORS) was used to assess study quality. Pre-to-post meta-analysis was performed for both anatomic and non-anatomic reconstructions. Results Twenty-eight studies were included comprising 799 patients (mean age of 36.6 years old and 84% males) with a mean follow-up of 34.6 months (range 13 to 74). Surgical techniques included anatomic (tendinous or synthetic grafts/constructs) and non-anatomic reconstruction (Weaver–Dunn or Modified Weaver–Dunn, conjoined tendon transfer, or temporary hook plate). There were significant pre-to-post improvements on the constant score with an average improvement ranging from 11.1 to 50.7 (p < 0.01). Average failure rate was 7.6% (7.5% for anatomic and 8.5% for non-anatomic reconstruction). Non-comparative studies had a mean MINORS score of 9 points (out of 16) and comparative studies 17 (out of 24) with excellent interrater agreement (k = 0.910). Conclusion Both anatomic and non-anatomic ACJ reconstructions provide significant post-operative improvements, but definitive conclusions on optimal technique remain elusive. Notwithstanding, comparative studies support the use of anatomic ACJ reconstruction which should be preferably used. However, until superiority is demonstrated by robust studies, surgeons should supplement their decision-making with experience and patient preference.
TypeArticle
URIhttps://hdl.handle.net/1822/67404
DOI10.1007/s00167-019-05408-3
ISSN0942-2056
e-ISSN1433-7347
Publisher versionhttps://link.springer.com/article/10.1007/s00167-019-05408-3
Peer-Reviewedyes
AccessRestricted access (UMinho)
Appears in Collections:ICVS - Artigos em revistas internacionais / Papers in international journals

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