Does Patient Sex Affect the Anatomic Relationships Between the Sternoclavicular Joint and Posterior Vascular Structures?

Merriman, Jarrad; Villacis, Diego; Wu, Brian; Patel, Dakshesh B.; Yi, Anthony; Hatch, George F. Rick

doi:10.1007/s11999-014-3853-x

Cited by 10 publications

(7 citation statements)

References 20 publications

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“…9,15 While uncommon, injuries to the SC joint can be severe because of the proximity to posterior vascular structures. 15,16 The risk of injuries to these and other nearby structures is higher with posterior dislocations 13,15 when compared with anterior dislocations. However, anterior dislocations are more common because of the greater strength of the posterior capsule, 13,24 with 1 biomechanical study finding 50% stronger force required to cause a posterior dislocation.…”

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confidence: 99%

Minimum 5-Year Clinical Outcomes, Survivorship, and Return to Sports After Hamstring Tendon Autograft Reconstruction for Sternoclavicular Joint Instability

et al. 2020

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Background: Instability of the sternoclavicular (SC) joint is a rare but potentially devastating pathologic condition, particularly when it occurs in young or active patients, where it can lead to persistent pain and impairment of shoulder function. SC joint reconstruction using a hamstring tendon autograft is a commonly used treatment option, but midterm results are still lacking. Purpose/Hypothesis: The purpose of this study was to assess the clinical outcomes, survivorship, and return-to-sports rate after SC joint reconstruction using a hamstring tendon autograft in patients suffering from SC joint instability. We hypothesized that SC joint reconstruction would result in good clinical outcomes, high rate of survivorship, and a high rate of return to sports. Study Design: Case series; Level of evidence, 4. Methods: All patients who underwent SC joint reconstruction with a hamstring tendon autograft for SC joint instability, with a minimum 5-year follow-up, were included. Patient-reported outcomes were assessed prospectively by the use of the American Shoulder and Elbow Surgeons (ASES) score, Single Assessment Numerical Evaluation (SANE) score, short version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) score, 12-Item Short Form Health Survey (SF-12) physical component summary (PCS), and patient satisfaction. Survivorship of reconstruction was defined as no further revision surgery or clinical failure such as recurrent instability or subluxation events. Return to sports and pain were assessed using a customized questionnaire. Results: A total of 22 shoulders that underwent SC joint reconstruction, with a mean patient age of 31.3 years (range, 15.8-57.0 years) at the time of surgery, were included. At the final evaluation, 18 shoulders, with a mean follow-up of 6.0 years (range, 5.0-7.3 years), completed a minimum 5-year follow-up. All clinical outcome scores improved significantly from preoperatively to postoperatively: ASES (50.0 to 91.0; P = .005), SANE (45.9 to 86.0; P = .007), QuickDASH (44.2 to 12.1; P = .003), and SF-12 PCS (39.4 to 50.9; P = .001). Median postoperative satisfaction was 9 (range, 7-10). The construct survivorship was 90% at 5-year follow-up. There were 2 patients with failed treatment at 82 and 336 days postoperatively because of instability or pain who underwent revision SC joint reconstruction and capsulorrhaphy. Another patient had a superficial wound infection, which was debrided once and resulted in a good clinical outcome. Of the patients who answered optional sports activity questions, 15 (17 shoulders, 77%) participated in recreational or professional sports before the injury. At final follow-up, 14 patients (16 of 17 shoulders, 94%) returned to their preinjury level of sports. The visual analog scale score for pain today ( P = .004) and pain at its worst ( P = .004) improved significantly from preoperatively to postoperatively. Conclusion: SC joint reconstruction with a hamstring tendon autograft for SC joint instability resulted in significantly improved clinical outcomes with high patient satisfaction and 90% survivorship at midterm follow-up. Furthermore, 94% of this young and high-demand patient population returned to their previous level of sports. Concerns in terms of advanced postinstability arthritis were not confirmed because a significant decrease in pain was found after a minimum 5-year follow-up.

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confidence: 99%

Minimum 5-Year Clinical Outcomes, Survivorship, and Return to Sports After Hamstring Tendon Autograft Reconstruction for Sternoclavicular Joint Instability

et al. 2020

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“…There are few articles that compare distances such as age, sex, and BMI. Merriman et al 14 found differences between the sexes, with a smaller distance from the medial clavicle to the BCV in females. Regarding these variables, our data demonstrate that the left SCJ is closer to the hilar structures than to the right side; in women both SCJ are closer to the BCV, esophagus and pulmonary apices compared to men; patients with BMI <25 have lower distances up to the BCV and esophagus.…”

Section: Discussionmentioning

confidence: 96%

Measuring the Distance Between Sternoclavicular Joint and Hilar Structures With Tomography

Sola¹,

Colferai²,

Ramos

et al. 2018

Acta ortop. bras.

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Objectives To evaluate the tomographic distance between the sternoclavicular joints and the nearest hilar structures.Methods Computed tomography images (axial and sagittal slices) in 120 healthy individuals (60 men and 60 women) between 18 and 60 years old were prospectively analyzed. The distances from both sternoclavicular joints to the respective brachiocephalic veins, trachea, esophagus, and lung apexes were measured and related to age, sex, and body mass index.Results Statistically significant differences were found in the distance from the right and left sternoclavicular joint distances and the corresponding brachiocephalic vein, esophagus, and lung apexes. In women, both sides were closer to the noble structures. In patients with body mass index <25, the distances were significantly less than in heavier patients.Conclusion The left sternoclavicular joint is closer to the hilar structures than the contralateral side. In women, both sternoclavicular joints are closer to the brachiocephalic veins, esophagus, and lung apexes than in men. Patients with body mass index <25 have shorter distances between these joints and the brachiocephalic veins and esophagus. Level of Evidence II; Prognostic studies – Investigating the effect of a patient characteristic on the outcome of disease.

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“…Despite the importance of these factors and the increasing prevalence of MRI, investigations into MR imaging of the clavicle and the SCJ remain limited. Nevertheless, some associations have been made, revealing correlations between clavicular parameters, sex, and age, primarily through CT scans and cadaver examinations of removed and prepared clavicles [ 12 , 30 ]. Existing literature also explores the measured asymmetry of the right and left clavicles in cadavers via direct measurement from removed, washed, and boiled clavicles as well as from radiographs [ 12 , 31 , 32 ].…”

Section: Discussionmentioning

confidence: 99%

Normative Values for Sternoclavicular Joint and Clavicle Anatomy Based on MR Imaging: A Comprehensive Analysis of 1591 Healthy Participants

Languth,

Prietzel,

Bülow

et al. 2024

JCM

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Background: The clavicle remains one of the most fractured bones in the human body, despite the fact that little is known about the MR imaging of it and the adjacent sternoclavicular joint. This study aims to establish standardized values for the diameters of the clavicle as well as the angles of the sternoclavicular joint using whole-body MRI scans of a large and healthy population and to examine further possible correlations between diameters and angles and influencing factors like BMI, weight, height, sex, and age. Methods: This study reviewed whole-body MRI scans from the Study of Health in Pomerania (SHIP), a German population-based cross-sectional study in Mecklenburg–Western Pomerania. Descriptive statistics, as well as median-based regression models, were used to evaluate the results. Results: We could establish reference values based on a shoulder-healthy population for each clavicle parameter. Substantial differences were found for sex. Small impacts were found for height, weight, and BMI. Less to no impact was found for age. Conclusions: This study provides valuable reference values for clavicle and sternoclavicular joint-related parameters and shows the effects of epidemiological features, laying the groundwork for future studies. Further research is mandatory to determine the clinical implications of these findings.

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Does Patient Sex Affect the Anatomic Relationships Between the Sternoclavicular Joint and Posterior Vascular Structures?

Cited by 10 publications

References 20 publications

Minimum 5-Year Clinical Outcomes, Survivorship, and Return to Sports After Hamstring Tendon Autograft Reconstruction for Sternoclavicular Joint Instability

Minimum 5-Year Clinical Outcomes, Survivorship, and Return to Sports After Hamstring Tendon Autograft Reconstruction for Sternoclavicular Joint Instability

Measuring the Distance Between Sternoclavicular Joint and Hilar Structures With Tomography

Normative Values for Sternoclavicular Joint and Clavicle Anatomy Based on MR Imaging: A Comprehensive Analysis of 1591 Healthy Participants

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