Background: Acromioclavicular (AC) joint dislocations are frequent, especially kocsisamong
young male athletes. While over 150 surgical techniques exist, consensus on optimal
treatment-particularly for Rockwood type III injuries-remains elusive. This study
evaluates the Lockdown procedure's efficacy, safety, and patient satisfaction, a synthetic
ligament technique for AC joint stabilization. Methods: A multicenter prospective
study was conducted on 39 patients across three Hungarian hospitals (2018-2023). Outcomes
included shoulder function, pain levels, and complication rates, with subgroup analysis
of acute (≤3 weeks) versus chronic (>3 weeks) cases. A systematic review of nine studies
(205 cases) was also performed to assess broader outcomes and complications. Results:
Significant improvements were observed in functional scores (OSS, Constant, DASH,
SST, ASES, Nottingham, Imitani) and pain reduction, especially in acute cases with
no prior shoulder surgery. The mean patient age was 38.9 ± 12.68 years, with a 24.5-month
average follow-up. OSS improvement between acute and chronic cases was 14.96 (95%
CI: 6.45-23.47; p = 0.0017). Complications (30.8%) occurred in eleven patients, mainly
minor infections; implant failure necessitated revision in 5.1%. The systematic review
reported a 34.6% complication rate (predominantly minor complications, like asymptomatic
subluxation -16%) and 5.4% implant removal due to failure. A meta-analysis was not
feasible due to data heterogeneity. Conclusions: The Lockdown procedure significantly
enhances shoulder function and reduces pain, particularly in acute dislocations. However,
the procedure showed a moderate complication rate, underscoring the need for careful
patient selection and postoperative management.
