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The prevalence of intraarticular associated lesions after acute acromioclavicular joint injuries is 20%. A systematic review and meta-analysis

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

To synthesise the evidence on the prevalence of associated intraarticular lesions in subjects with acute acromioclavicular joint (ACJ) dislocations.

Methods

A search in two electronic databases (PUMBMED and EMBASE) was performed from 1985 to 2019. Two independent reviewers selected studies that complied with the following inclusion criteria: (1) the study included data on surgically treated ACJ dislocation grade III–V in the Rockwood classification, (2) the ACJ injuries were acute (the surgery was performed less than 6 weeks after injury), (3) an arthroscopic evaluation of the glenohumeral joint was performed during surgery. The quality of the studies included was assessed using the tool of the Joanna Briggs Institute.

Results

A total of 47 studies with acute ACJ injuries met the initial inclusion criteria. Of these, 21 studies (9 retrospective case series, 9 prospective case series and 3 retrospective cohort studies) presented data on associated intraarticular lesions amenable for use in the meta-analysis. The meta-analysed studies included a total of 860 subjects with acute ACJ dislocations with a male/female ratio of 6.5 and a mean age of 32 years. The meta-analysis showed a prevalence of associated intraarticular lesions in subjects with acute ACJ of 19.9% (95% confidence interval [CI] 14.0–26.4%; 21 studies, 860 analysed participants; P = 0.000; I2: 74.5% random-effects model; low risk of bias).

Conclusion

One in five subjects with surgically treated acute ACJ dislocations will have an associated intraarticular lesion that requires further intervention. The case for a customary arthroscopic evaluation of the joint, even when an open procedure is performed to deal with the ACJ dislocation, is strong.

Level of evidence IV

Trial registry Systematic review registration number: PROSPERO CRD42018090609.

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Authors and Affiliations

  1. Unidad de Hombro Y Codo, Hospital Universitario Ramón Y Cajal, Cta Colmenar km 9,100, Madrid, Spain

    Miguel Angel Ruiz Ibán, Miguel Santiago Moreno Romero, Jorge Diaz Heredia & Raquel Ruiz Díaz

  2. Unidad de Bioestadística Clínica, Hospital Ramón Y Cajal, IRYCIS, CIBERESP, Madrid, Spain

    Alfonso Muriel & Jesus López-Alcalde

  3. Departamento de Enfermería, Universidad de Alcalá, Madrid, Spain

    Alfonso Muriel

  4. Faculty of Health Sciences, Universidad Francisco de Vitoria (UFV)-Madrid, Madrid, Spain

    Jesus López-Alcalde

  5. Cochrane Associate Centre of Madrid, Madrid, Spain

    Jesus López-Alcalde

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  1. Miguel Angel Ruiz Ibán
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  2. Miguel Santiago Moreno Romero
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  3. Jorge Diaz Heredia
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Correspondence to Miguel Angel Ruiz Ibán.

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Ruiz Ibán, M.A., Moreno Romero, M.S., Diaz Heredia, J. et al. The prevalence of intraarticular associated lesions after acute acromioclavicular joint injuries is 20%. A systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc 29, 2024–2038 (2021). https://doi.org/10.1007/s00167-020-05917-6

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