Introduction
Methods
Eligibility criteria
Literature search
Data extraction and quality assessment
Statistical analysis
Results
Study selection and characteristics
Authors | LOE | Country | Patients (n) Hook-button | Age (years) Surg-Cons | Gender | Rockwood classification | Follow-up (months) | Outcome Hook-button |
---|---|---|---|---|---|---|---|---|
Sokkar [19] | II | Egypt | 10 10 | 35.2 + 8.2 | M = 15 F = 5 | III | 11.7 + 1.6 11.3 + 2.6 | UCLA 32.2 + 2.33–32.5 + 2.22 VAS 9.2 + 1.03–9.3 + 1.0 |
Cai [20] | II | China | 39 30 | 41.8 + 10.2 42.8 + 11.9 | M = 26 F = 13 M = 19 F = 11 | III | 12 | Constant 92.6 + 6.4–92.0 + 6.7 VAS 1.92 + 1.11–0.97 + 1.03 |
Pongsamakthai and Tharakulphan [21] | II | Thailand | 22 22 | 39.6 + 9.6 37.1 + 11.5 | M = 17 F = 5 M = 16 F = 6 | III–V | 3 | Constant 81.6 + 5.7–90.4 + 3.5 |
Stein [22] | II | Germany | 27 39 | 37.6 + 9.7 34.2 + 9.7 | M = 26 F = 1 M = 28 F = 1 | III–V | 40.1 30.7 | Taft 9.41 + 1.69–10.9 + 1.08 Constant 90.2 + 7.8–95.3 + 4.4 VAS 2.44 + 2.99–1.74 + 1.86 |
Andreani [23] | III | Italy | 9 19 | 32.3 (19–60) | M = 22 F = 8 | IV-VI | 24 (6–48) | Constant 75 (65–85)–90 (74–99) UCLA 80–95 |
Metzlaff [24] | III | Germany | 20 24 | 37.6 (18–56) | M = 44 F = 9 | III–V | 32 (24–51) | Constant 92.8 + 3.8–93.6 + 3.4 Taft 10.5 + 1.2–10.9 + 0.9 |
Jensen [25] | III | Germany | 30 26 | 39 (18–68) 39 (18–54) | M = 28 F = 2 M = 23 F = 3 | III | 48 (7–77) 17 (7–29) | Constant 88 (20–99)–89 (52–100) Taft 10 (3–12)–10 (5–12) VAS 1.7 + 2.3–1.3 + 1.8 SST 10.4 + 2.8–11.0 + 1.3 |
Natero-Cisneros [26] | III | Spain | 11 20 | 41 (19–55) 36 (25–52) | M = 11 F = 0 M = 17 F = 3 | III–V | 32.5 + 11.6 38.4 + 4.3 | VAS 1.45 + 1.51 Constant 91.4 + 6.84–95.3 + 0.93 DASH 4.8 + 5.6–3.0 + 2.0 |
Razak [27] | III | Singapore | 10 16 | 49.2 + 16.9 41.4 + 12.3 | M = 6 F = 4 M = 9 F = 1 | III–V | 23 (14–35) | Constant 48.1 + 26.9–38.7 + 18.2 OSS 14.3 + 3–13.3 + 5 VAS 7.3 + 7.9–3.3 + 5.5 |
Taleb [28] | III | Iran | 8 9 | 39.6 + 16.2 37.3 + 12.02 | M = 7 F = 1 M = 8 F = 1 | III–IV | 19.8 + 8.8 23.8 + 19.2 | VAS 7.6 + 9.5–3.2 + 8.9 DASH 73.1 + 22.1–39.4 + 11 ASES 47.9 + 27.4–87.6 + 10.4 UCLA 21 + 7–32.2 + 1.4 Constant 55 + 22.9–91.7 + 5.9 SST 5.3 + 3.2–10.5 + 1.45 |
Li 2020 | III | China | 84 28 | 36.0 + 8.3 35.9 + 7.9 | M = 63 F = 21 M = 21 F = 7 | III–V | 24 | VAS 1.8 + 1.1–1.2 + 0.6 Constant 83.3 + 8.8–89.3 + 4.2 |
Fosser [30] | III | Italy | 22 22 | 48.2 (22–70) 40.5 (21–63) | M = 16 F = 6 M = 20 F = 2 | III–V | 41.3 (6–58) 32.2 (6–46) | Constant 92.7 (80–100)–96.1 (72–100) |
Shen [31] | III | China | 19 16 | 40.2 + 8.7 44.9 + 11 | M = 10 F = 9 M = 10 F = 6 | III, IV | 30 (16–40) 27 (15–42) | Constant 93.7 + 6.6–95.7 + 7.3 VAS 0.7 + 0.6–0.4 + 0.6 UCLA 33.7 + 1.5–33.9 + 2.5 |
Yoo [32] | III | Korea | 10 12 | 44.4 + 6.5 42.8 + 5.5 | M = 7 F = 3 M = 8 F = 4 | III, IV | 31.5 (24–62) | VAS 1.14 + 1.45–1.02 + 1.32 ASES 72.2 + 12.96–86.32 + 13.46 SPADI 35.2 + 11.5–23.2 + 10.5 DASH 38.8 + 7.6–22.2 + 12.5 |
Liu [33] | III | China | 39 32 | 41.8 + 10.5 39.6 + 8.9 | M = 29 F = 10 M = 23 F = 9 | III | 12 | Constant 94.4 + 3.2–94.8 + 3.5 DASH 4.5 + 3.3–4.6 + 3.9 VAS 0.4 + 0.8–0.3 + 0.8 |
Risk of bias and quality assessment
Authors | LOE | Bias due to confounding | Bias in selection of participants | Bias in classification of interventions | Bias due to deviations from intended interventions | Bias due to missing data | Bias in measurement of outcomes | Bias in selection of the reported results | Overall bias |
---|---|---|---|---|---|---|---|---|---|
Andrani 2013 | III | Moderate | Moderate | Serious | Moderate | Low | Low | Low | Serious |
Metzlaff [24] | III | Moderate | Moderate | Moderate | Low | Low | Low | Low | Moderate |
Jensen [25] | III | Moderate | Low | Low | Low | Low | Moderate | Low | Moderate |
Natero-Cisneros [26] | III | Moderate | Serious | Moderate | Low | Moderate | Low | Low | Serious |
Razak [27] | III | Moderate | Low | Low | Low | Low | Low | Low | Moderate |
Taleb [28] | III | Critical | Critical | Low | Low | Low | Low | Low | Critical |
Li 2020 | III | Moderate | Moderate | Low | Low | Low | Low | Low | Moderate |
Fosser [30] | III | Moderate | Moderate | Serious | Low | Low | Low | Low | Serious |
Shen [31] | III | Moderate | Moderate | Low | Low | Low | Low | Low | Moderate |
Yoo [32] | III | Moderate | Moderate | Serious | Low | Serious | Low | Low | Serious |
Liu [33] | III | Moderate | Moderate | Low | Low | Low | Low | Low | Moderate |
Risk of bias Cochrane assessment tool version 2
Risk of bias ROBINS-I assessment tool
Quality assessment
Authors | Initial level of certainty | Final level of certainty | Risk of bias | Inconsistency of results | Indirectness of evidence | Imprecision of results | Large effects (upgrading) | Dose response (upgrading) | Opposing plausible residual bias and confounding (upgrading) |
---|---|---|---|---|---|---|---|---|---|
Clinical outcomes all studies | Low | Very low | High | Considerable I2 | N/A | 95% CI missing | N/A | N/A | N/A |
Clinical outcomes LOE II studies | High | Very low | High | Considerable I2 | N/A | 95% CI missing | N/A | N/A | N/A |
Clinical outcomes LOE III studies | Low | Very low | High | Considerable I2 | N/A | 95% CI missing | N/A | N/A | N/A |
VAS all studies | Low | Very low | High | Considerable I2 | N/A | ||||
VAS LOE II studies | Low | Very low | High | Considerable I2 | N/A | 95% CI missing | N/A | N/A | N/A |
VAS LOE III studies | Low | Very low | High | Considerable I2 | N/A | 95% CI missing | N/A | N/A | N/A |
Authors | Total points | Clearly stated aim | Inclusion of consecutive patients | Prospective collection of data | Appropriate endpoints | Unbiased assessment | Follow-up appropriate | Loss of follow-up < 5% | Sample size calculation | Control group | Contemporary groups | Baseline group equivalence | Adequate statistical analysis |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Sokkar [19] | 7 | 0 | 2 | 0 | 2 | 0 | 1 | 0 | 0 | 0 | 2 | 0 | 0 |
Cai [20] | 17 | 2 | 2 | 2 | 2 | 0 | 1 | 2 | 0 | 0 | 2 | 2 | 2 |
Pongsamakthai and Tharakulphan [21] | 19 | 2 | 2 | 2 | 2 | 0 | 1 | 2 | 2 | 0 | 2 | 2 | 2 |
Stein [22] | 18 | 2 | 2 | 2 | 2 | 0 | 2 | 0 | 2 | 0 | 2 | 2 | 2 |
Andreani [23] | 8 | 0 | 2 | 0 | 2 | 0 | 2 | 0 | 0 | 0 | 2 | 0 | 0 |
Metzlaff [24] | 16 | 2 | 2 | 0 | 2 | 0 | 2 | 2 | 2 | 0 | 2 | 0 | 2 |
Jensen[25] | 11 | 2 | 2 | 0 | 2 | 0 | 1 | 0 | 0 | 0 | 2 | 0 | 2 |
Natero-Cisneros [26] | 10 | 2 | 0 | 0 | 2 | 0 | 2 | 0 | 0 | 0 | 2 | 0 | 2 |
Razak [27] | 18 | 2 | 2 | 2 | 2 | 0 | 0 | 2 | 2 | 0 | 2 | 2 | 2 |
Taleb [28] | 11 | 2 | 0 | 0 | 2 | 0 | 1 | 0 | 0 | 0 | 2 | 2 | 2 |
Li 2020 | 12 | 2 | 0 | 0 | 2 | 0 | 2 | 0 | 0 | 0 | 2 | 2 | 2 |
Fosser [30] | 12 | 2 | 0 | 0 | 2 | 0 | 2 | 0 | 0 | 0 | 2 | 2 | 2 |
Shen [31] | 13 | 2 | 0 | 0 | 2 | 0 | 2 | 1 | 0 | 0 | 2 | 2 | 2 |
Yoo [32] | 12 | 2 | 0 | 0 | 2 | 0 | 2 | 0 | 0 | 0 | 2 | 2 | 2 |
Liu [33] | 10 | 0 | 0 | 0 | 2 | 0 | 1 | 1 | 0 | 0 | 2 | 2 | 2 |
Authors | Total points | Study size | Mean follow-up | Percent of patients with follow-up | Number of interventions | Type of study | Diagnostic certainty | Description surgical technique | Description postoperative rehabilitation | Outcome criteria | Procedures for assessing outcomes | Description of subject selection |
---|---|---|---|---|---|---|---|---|---|---|---|---|
Sokkar [19] | 43 | 0 | 0 | 3 | 10 | 10 | 5 | 5 | 0 | 10 | 5 | 0 |
Cai [20] | 64 | 4 | 0 | 5 | 10 | 15 | 5 | 5 | 0 | 10 | 5 | 5 |
Pongsamakthai and Tharakulphan [21] | 64 | 4 | 0 | 5 | 10 | 15 | 5 | 5 | 0 | 10 | 5 | 5 |
Stein [22] | 69 | 4 | 0 | 5 | 10 | 15 | 5 | 5 | 0 | 10 | 5 | 10 |
Andreani [23] | 45 | 0 | 0 | 5 | 10 | 0 | 5 | 5 | 0 | 10 | 5 | 5 |
Metzlaff [24] | 60 | 0 | 5 | 10 | 10 | 0 | 5 | 5 | 5 | 10 | 5 | 5 |
Jensen [25] | 73 | 4 | 5 | 10 | 10 | 0 | 5 | 5 | 5 | 10 | 9 | 10 |
Natero-Cisneros [26] | 60 | 0 | 0 | 5 | 10 | 0 | 5 | 5 | 5 | 10 | 5 | 15 |
Razak [27] | 55 | 0 | 0 | 5 | 10 | 10 | 5 | 5 | 5 | 10 | 5 | 5 |
Taleb [28] | 43 | 0 | 0 | 3 | 10 | 5 | 5 | 0 | 0 | 10 | 5 | 5 |
Li 2020 | 60 | 7 | 0 | 3 | 10 | 0 | 5 | 5 | 5 | 10 | 5 | 10 |
Fosser [30] | 59 | 4 | 0 | 5 | 10 | 0 | 5 | 5 | 5 | 10 | 5 | 10 |
Shen [31] | 54 | 0 | 0 | 5 | 10 | 0 | 5 | 5 | 5 | 10 | 9 | 5 |
Yoo [32] | 45 | 0 | 0 | 0 | 10 | 0 | 5 | 5 | 5 | 10 | 5 | 5 |
Liu [33] | 64 | 4 | 0 | 5 | 10 | 5 | 5 | 5 | 10 | 10 | 5 | 5 |
Clinical outcomes
Clinical outcomes for pain
Complications
Authors | Hook plate | Button | Percentage hook plate (%) | Percentage button (%) |
---|---|---|---|---|
Sokkar [19] | Infection 2 Osteolysis 2 | Failure 1 | 40 | 10 |
Cai [20] | Infection 3 Nerve injury 1 Hardware related 1 | Re-dislocation 0–3 | 12.8 | 10 |
Stein [22] | Horizontal instability: 5 | Horizontal instability: 3 | 18.5 | 7 |
Andreani [23] | None reported | Pain 1 Hardware related 2 | 0 | 15.8 |
Metzlaff [24] | None reported | Loss of reduction 1 | 0 | 4.2 |
Jensen [25] | Wound complications 12 ACJ OA 8 Hardware related 4 Erosion 6 | ACJ OA 5 Loss of reduction: 3 Hardware related 1 | 80 | 34.6 |
Natero-Cisneros [26] | Erosion 1 Implant failure 1 Infection 1 | Implant failure 1 Infection 2 | 27.3 | 15 |
Razak [27] | Plate cut-out 1 Erosion 2 | Infection 2 | 30 | 6.2 |
Pongsamakthai and Tharakulphan [21] | Late 1 Loss of reduction 1 | Early 3 Late 1 Loss of reduction 5 | 9.1 | 40.9 |
Taleb [28] | Erosions 6 | None reported | 75 | 0 |
Li 2020 | Infection 2 Loss of reduction 10 | Loss of reduction 2 | 11.9 | 7.1 |
Fosser [30] | None reported | Recurrence 1 | 0 | 4.5 |
Shen [31] | Acromial erosion: 1 | Loss of reduction 1 | 2.1 | 2.0 |
Yoo [32] | ACJ OA 4 | None reported | 40 | 0 |
Liu [33] | Shoulder pain 1 Osteolysis 1 Distal clavicle fracture 1 | Infection 0–1 | 7.7 | 3.1 |