Surgical Treatment of Acromioclavicular Dislocations: A Scoping Review




Tran, Apollo
Beal, Jennifer
Powell, Jake


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Background. While AC joint dislocation accounts for 3.2% of all shoulder injuries, there is still debate on the optimal surgical approach. Over 150 surgical variations have been proposed for AC joint reconstruction. The literature for reconstruction varies widely by technique and focus of analysis, focusing on either clinical or biomechanical studies. Objective. This study aims to clarify research on the most commonly conducted AC joint reconstruction procedures by combining clinical and biomechanical studies into an organized review. In addition, we will identify new procedure designs and evaluate them for possible application in future reconstructive surgeries. Methods.We will complete a literature review to identify biomechanical studies on AC joint fixation using Medline, Scopus, and Excerpta Medica Database (EMBASE) following the 2009 PRISMA statement. Articles will be independently reviewed by at minimum two investigators and any disagreements will be reconciled by consensus in consultation with a third investigator. Results. Analysis of the most commonly performed procedures combines the biomechanical and clinical research associated with each technique. Results are categorized into ligament reconstruction and fixation. Ligament reconstruction pertains to the techniques of Modified Weaver-Dunn, autograft, and allograft. Fixation techniques will include Hook plate, Coracoclavicular Screw Fixation (Bosworth), Cortical Flip Button (endobutton), and K wire fixation. Conclusion. Past reviews focused solely on clinical or biomechanical aspects of AC joint reconstruction, rarely combining the two fields of study. Our review aims to join the different modes of study to provide a clearer picture of technique outcomes.