Outcomes After Operative Versus Nonoperative Management of Type III to V Acromioclavicular Joint Dislocations: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Study Summary

5 randomized controlled trials (RCTs) including 367 patients with acute Rockwood type III to V acromioclavicular joint (ACJ) dislocations were included in this systematic review and meta-analysis comparing operative versus nonoperative management. Outcomes of interest included Constant scores, patient-reported outcome measures (PROMs), cosmetic satisfaction, radiographic findings, range of motion, return to work or sport, complications, and unplanned surgery. Nonoperative treatment resulted in better early shoulder function and faster return to work, while functional outcomes, patient satisfaction, and return to work or sport were comparable between groups at longer follow-up. Operative management improved radiographic alignment but was associated with more minor complications. Overall, these findings suggested that nonoperative management was a reasonable initial treatment for most patients with Rockwood type III to V ACJ dislocations.