Meta Analysis Of Conservative Or Surgical Treatment Of Operative Versus Non-operative Management Following Rockwood Grade ⅢAcromioclavicular Joint Dislocation

ObjectiveBy choosing high-quality controlled clinical trials To analyze the clinical efficacy of conservative and surgical treatments on acromioclavicular joint dislocation of Rockwood Ⅲ through Meta-analysis of the literature published at home and abroad. ByMethodAccording to Cochrane systematic review methods,the literature were identified from specialized trials registered in MEDLINE, Embase, ISI Web of Science,additional electronic searched for corresponding Chinese Journals(including CNKI, CBM and WAN FANG DATA). Papers about the comparison of surgery and conservative therapy trials of Rockwood III acromioclavicular joint dislocation were collected. The quality of articles were evaluated by the standards of the Cochrane Collaboration, Meta-analysis was used to analyze the extracted data by ReVMan5.0.ResultsA total of nine studies were extracted and analyzed,577cases of these articles with acromioclavicular joint dislocation were counted in, of which313cases were surgical group,264cases for conservative group. After Meta analysis by using RevMan software, we concluded that:compared with conservative treatment of Rockwood Ⅲ acromioclavicular joint dislocation patients, the surgery treatment resume working hours after treatment showed statistically significant [SMD=-1.34,95%CI (-1.79,-0.89), P=0.64], no significant difference in relapse rate after treatment [OR=1.91,95%CI(0.63,5.75), P=0.25], Osteoarthritis appearance was statistically difference after treatment [OR=0.04,95%CI(0.00,0.29), P=0.002], bacterial infections probability difference was statistically significant [OR=0.22,,95%CI(0.05,1.01), P=0.05], no significant difference in the strength index [OR=1.69,95%CI(0.44,6.44), P=0.44], persistent pain conditions showed no significant difference [OR=1.09,95%CI(0.49,2.43), P=0.84], the prognosis of functional scores showed no significant difference [SMD=-0.38,95%CI (-0.81,0.05), P=0.08], no statistical difference between good rate [OR=1.39,95%CI(0.60,3.21), P=0.45].ConclusionThe results showed that surgical treatment and conservative treatment in the recovery of limb function and prognosis both achieved satisfactory results and no significant difference were found. Although the time of conservative treatment in terms of participation in physical activity or back to work was significantly better than surgery, at the same time, complications after surgery impacts on the prognosis of functional recovery. After all, we concluded that the conservative treatment should be a better choice to therapy the Rockwood III acromioclavicular joint dislocation.