Surgical treatment of sternoclavicular joint osteoarthritis: a systematic review
Anna H N Rasmussen1, Michael R Krogsgaard1
1Section for Sports Traumatology M51, Department of Orthopedic Surgery, Copenhagen University Hospital Bispebjerg, Copenhagen NV, Denmark.
Background:
Sternoclavicular joint (SCJ) osteoarthritis is rarely treated surgically, and the available published manuscripts are limited to small patient series. The aims of this systematic review were to identify the surgical treatment options for osteoarthritis of the SCJ, describe the quality of the available literature, analyze the outcome and complications, and compare open vs. arthroscopic surgery.
Methods:
Literature was searched in PubMed, MEDLINE, and Embase. Single case reports and studies that did not include surgical management were excluded. Data of interest included study year, sample size, diagnosis, sex, age, demographics, clinical data, type of surgical management, follow-up periods, outcomes, and complications related to the surgical treatment.
Results:
Eight articles on series of patients met the inclusion criteria and included 107 patients. Mean patient age was 48.2 years (range: 17-72). 68% of patients were females and 32% males. The most commonly described treatment option was arthroscopic resection of the medial clavicle end (56%). Revision surgery was performed in 3 cases: 2 following trauma and 1 for persistent pain. The mean follow-up period was 45.4 months (range: 28-80). Scores from patient-reported outcome measures (Rockwood, Constant, and Disabilities of the Arm, Shoulder, and Hand questionnaires) and visual analog scale pain scores all improved significantly from preoperatively to postoperatively. Four studies with 32 patients reported the overall subjective patient outcome with 84% reaching excellent or good. There were no randomized controlled trials and no comparative cohorts. Arthroscopic surgery was only reported by 1 center, and this may induce risk of bias. It was not possible to compare outcomes following open and arthroscopic surgery.
Conclusion:
Based on this systematic review, surgical treatment of SCJ osteoarthritis is a safe procedure which offers good pain reduction and a high rate of satisfaction. It is not possible from literature to conclude whether open or arthroscopic surgery is preferable.
