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Study: AC joint dislocation can be treated better without surgery

Acromio-Clavicular (AC) joint dislocation, commonly known as a common shoulder dislocation can be treated better without a surgery, according to a new study published in the Journal of Orthopaedic Trauma by the lead author Dr. Michael McKee.ac-joint-dislocation

According to the study, If a patient with severe common shoulder dislocation injury opt-out of surgery experience (doctors often prefer surgery for AC joint dislocation) experience lesser complications than the patients who opt-in for a surgery and return to normal life sooner.

The Acromio-Clavicular (AC) joint is located at the topmost side of the shoulder, between the collarbone on top of the blade of the shoulder. People often get this injury due to many reasons that includes sports injuries, car accidents, during physical activities and falls.

Dr. Michael McKee, an orthopedic surgeon with St. Michael’s Hospital, stated in the study:

“For severe AC joint dislocations, surgery is the common practice but there’s not much evidence to suggest this is actually the best treatment. Three months after the initial injury, more than 75 per cent of the patients who did not have an AC joint surgical repair were able to return to work, whereas only 43 per cent of those who underwent surgery were back at work.”

As of now, surgery is the most common practice if a patient gets a severe AC joint dislocation, however, the minor AC joint dislocation injuries gets a sling and a physiotherapy recommendation by the doctors around the world.

The authors of this study have followed 83 AC joint dislocation patients, including moderate and severe injuries. 40 of these patients had to undergo a surgery, while 43 patients were assigned a sling and physiotherapy treatment. Researchers have followed these patients for 2 years to find their complications, their level of satisfaction and levels of disability, along with how the shoulder look changes after the surgery.

The study also shows that patients with a sling and rehabilitation treatment had greater mobility at the first six weeks and 3 months in follow-up period. There were no any significant differences between the two groups during the first 6-month follow-up study.

7 people out of the total patients who underwent the surgery for the injury experienced major complications, while seven of them experienced minor complications. Surprisingly, only 2 of the 43 patients who opt-in for sling and rehabilitation treatment experienced major complications. These major complications were because of the repeated falls and injury of the shoulder.

“The main advantages of surgery are that the joint is put back in place and the shoulder appears more symmetrical and pleasing to the eye,” said Dr. McKee. “The long-term implications of surgery for AC joint dislocation remain unclear when compared to non-operative treatment.”

Meanwhile, in the levels of satisfaction segment, people with surgery had less number of dissatisfaction reports (5 percent), where the group of patients with sling and rehabilitation had more number of dissatisfaction reports (16 percent). These dissatisfactions was not about the complications, but about the appearance of the shoulder after healing the injury, as it wasn’t placed in its right place due to non-surgery. After two years, the dissatisfaction increased in the sling and rehabilitation group to 21 percent.

Dr. McKee concluded, “While satisfaction with the appearance of the shoulder should be a consideration, I believe surgeons should think twice before recommending surgery for an AC joint dislocation – regardless of the severity. Patients who forgo surgery return to work sooner, experience less disability during the first months after injury and have fewer complications.”

The study was published today in the Journal of Orthopaedic Trauma

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