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Title of Journal: International Orthopaedics SICOT

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Abbravation: International Orthopaedics

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Springer Berlin Heidelberg

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10.1016/0091-3057(91)90436-6

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1432-5195

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Comment on Korsten et al Operative or conservati

Authors: Hongbin Guo Tao Xiao
Publish Date: 2014/02/04
Volume: 38, Issue: 4, Pages: 915-915
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Abstract

In this systematic review Korsten et al 1 reviewed the current literature and presented an overview of the outcome of conservative versus operative treatment of Rockwood type III dislocations They found that the objective and subjective shoulder function outcome was better in the operative group especially in young adults though the rate of complications and radiographic abnormalities were higher The rehabilitation time was shorter in the conservative group however the cosmetic outcome was worse It is a very valuable study Nevertheless there are some questions we would like to ask related to this articleTo begin with the investigators calculated the results of subjective shoulder function complications osteoarthritis calcification and cosmetic outcome by using SPSS version 200 However they did not provide the concrete statistical methods for these comparisons which might reduce its credibility We are wondering how to calculate these results such as 313 versus 277 p = 0406 and so on To solve these potential problems we suggest that a metaanalysis should be conducted to compare the subjective shoulder function complications osteoarthritis calcification and cosmetic outcome between operative and conservative groupsFinally the investigators did not compare the outcomes of the objective shoulder function in the studies which we consider as the most important outcome of AC joint injuries Therefore we suggest that at a minimum the investigators should describe the details of objective shoulder function in different studiesWe agree that physically active young adults seem to have a slight advantage in outcome when treated operatively In our opinion more randomized clinical trials with longterm followup should be conducted to provide evidence for the best treatment in patients with Rockwood type III AC dislocations

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