Study found that patients who choose non-surgical treatment experience better mobility, fewer complications and return to work sooner.
Acromioclavicular (AC) joint dislocation is a common injury to the shoulder. It generally occurs in car accidents, falls and sports injuries when someone directly lands onto the point of the shoulder and ends up tearing ligaments partially or completely.
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Dislocated shoulder is mostly treated by surgery. But it may not be the best option to opt for. According to new research, patients who undergo rehabilitation and avoid surgical treatments, recover faster and experience less pain and complications.
"For severe AC joint dislocations, surgery is the common practice but there's not much evidence to suggest this is actually the best treatment.” Lead author Dr. Michael McKee, an orthopedic surgeon from St. Michael's Hospital in Toronto said in a news release.
The study, published in Journal of Orthopedic Trauma, suggests that patients who choose non-surgical treatment were able to move their shoulders better than those who had surgery at follow up sessions six weeks and three months after the injury.
For the study, researchers recruited 83 patients with dislocated AC joints. 40 of them were treated with surgery and the remaining 43 with nonoperative methods (wore sling or flexible strap and had physical therapy).
The participants were followed for the next two years. The level of disability, complications and satisfaction with shoulder appearance were taken into account.
Research found that those who decided against the surgery had fewer complications and got back to the work after the period of three months. Patients who chose operative repair could not return to work but were more satisfied with the appearance of their shoulder after treatment.
"Three months after the initial injury, more than 75 percent of the patients who did not have AC joint surgical repair were able to return to work, whereas only 43 percent of those who underwent surgery were back at work.” McKee said.
Of 40 surgical patients, many had developed complications like loose plate and deep wound infection. However, patients with non-surgical treatment were not as happy with the appearance of their shoulder as surgical patients were and the level of dissatisfaction increased after two years.
“The main advantaged of surgery are that the joint is put back in place and shoulder appears more symmetrical and pleasing to the eye,” said McKee. “The long-term implications of surgery for AC joint dislocation remain unclear when compared to nonopreative treatment.”
Dr. Mckee recommends that patients should think twice before undergoing surgery no matter how severe the condition is.
“Patients who forgo surgery return to work sooner, experience less disability during the first months after the injury and have fewer complications.” He concludes.