Relationship of the Medial Clavicular Head to the Manubrium in Normal and Symptomatic Degenerated Sternoclavicular Joints

Tongel, Alexander Van; Valcke, Jens; Piepers, Iwein; Verschueren, Thomas; Wilde, Lieven De

doi:10.2106/jbjs.m.00623

Cited by 8 publications

(5 citation statements)

References 24 publications

(23 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In our population, local swelling was most commonly seen in patients with signs of degenerative arthritis on CT. This correlated with the findings of Van Tongel et al who described an anterior subluxation of the clavicle in patients with symptomatic degenerative arthritis [ 24 ]. This hard prominence is in contrast with the temporary local swelling in patients with transient SC arthropathy without any signs of degeneration [ 1 ].…”

Section: Discussionsupporting

confidence: 90%

Diagnostic value of active protraction and retraction for sternoclavicular joint pain

Tongel

Karelse

Berghs

et al. 2014

BMC Musculoskelet Disord

Self Cite

View full text Add to dashboard Cite

BackgroundSternoclavicular joint (SCJ) arthropathy is an uncommon cause of mechanical pain. The aim of this study is to evaluate the diagnostic value of two active clinical tests for localizing the sternoclavicular joint as the source of mechanical pain.MethodsAll patients between June 2011 and October 2013 that visited the orthopedic departments of three hospitals with atraumatic pain in the area of the SC joint were evaluated. Local swelling, pain at palpation, pain during arm elevation and two newly described tests (pain during active scapular protraction and retraction) were evaluated. CT images were evaluated. The patients were then divided into two groups according to whether they had a ≥50% decrease in pain following the SCJ injection. Sensitivity and specificity for local swelling, the four clinical tests and CT-scan were measured.ResultsForty eight patients were included in this study and SC joint pain was confirmed in 44. The tests with highest sensitivity were pain on palpation, (93% sensitivity) and pain during active scapular protraction (86%). CT-scan showed a sensitivity of 84%. Local swelling showed a high specificity (100%).ConclusionPain at the SCJ during active scapular protraction is a good clinical diagnostic tool for SC arthropathy.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2474-15-421) contains supplementary material, which is available to authorized users.

show abstract

Section: Discussionsupporting

confidence: 90%

Diagnostic value of active protraction and retraction for sternoclavicular joint pain

Tongel

Karelse

Berghs

et al. 2014

BMC Musculoskelet Disord

Self Cite

View full text Add to dashboard Cite

show abstract

“…Standard preoperative workup included radiographs of the affected SC joint ( Figure 1) as well as a computed tomography angiogram or magnetic resonance imaging to evaluate both the SC joint and the surrounding vascular structures (Figure 2). 9,22…”

Section: Methodsmentioning

confidence: 99%

Minimum 5-Year Outcomes and Return to Sports After Resection Arthroplasty for the Treatment of Sternoclavicular Osteoarthritis

et al. 2020

View full text Add to dashboard Cite

Background: Osteoarthritis of the sternoclavicular (SC) joint is a rare condition that leads to decreased function and persistent pain, ultimately altering the function of the shoulder and keeping individuals from their desired activities. SC resection in the setting of primary and posttraumatic osteoarthritis is the most common surgical treatment for these patients, but midterm results are lacking. Purpose/Hypothesis: The purpose was to assess the clinical outcomes, pain levels, return to sports rate, and survivorship after open SC joint resection in the setting of painful primary SC joint osteoarthritis. We hypothesized that an SC joint resection of maximum 10 mm would result in a significant improvement in clinical outcomes, decreased pain levels, a high rate of return to sports, and a high survivorship. Study Design: Case series; Level of evidence, 4. Methods: Patients who underwent SC joint resection (maximum 10 mm) by a single surgeon between the years 2006 and 2013 with minimum 5-year follow-up were reviewed. The following clinical outcomes were collected prospectively during this time period: 12-Item Short Form Health Survey Physical Component Score (SF-12 PCS), American Shoulder and Elbow Surgeons (ASES) score, Single Assessment Numerical Evaluation (SANE) score, Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) score, and patient satisfaction. Return to sports and pain were assessed through use of a customized questionnaire. Survivorship of SC joint resection was defined as not requiring further surgery on the affected joint. Results: A total of 21 SC joints were treated with resection of the medial clavicle and intra-articular disk and capsulorrhaphy for SC joint osteoarthritis in 19 patients with a mean age of 39.4 years (range, 12.5-66.7 years). At minimum 5-year follow-up, 19 SC joint resections were assessed in 16 of 19 patients (84%) with a mean follow-up of 6.7 years (range, 5.0-10.4 years). All outcome scores improved significantly from pre- to postoperative assessments: ASES (from 54 to 90.5; P = .003), SANE (from 61.8 to 90.4; P = .004), QuickDASH (from 43.1 to 13.8; P = .004), and SF-12 PCS (from 39.8 to 51.3; P = .004). Median satisfaction with surgical outcomes was 9 (range, 2-10), and pain levels improved from a score of 8 out of 10 to 3 out of 10 (scale of 0 to 10 with 0 being pain free and 10 worst possible pain). Of the 13 patients who answered the optional sports participation question, 13 (100%) patients had participated in sports before their injury. A total of 14 patients answered the question on sports participation after injury, with 12 (86%) indicating successful return to sports. Pain at its worst ( P = .003) and pain with competition ( P = .017) significantly decreased pre- to postoperatively. Resection survivorship at final follow-up was 84.2% at 5 years. We found that 3 patients (15%) had recurrent SC joint pain and were treated with revision surgery. Conclusion: Open SC resection arthroplasty with capsulorrhaphy in the setting of pain for SC osteoarthritis results in significant improvement in clinical outcomes, patient satisfaction, return to sports, and pain reduction at minimum 5-year follow-up.

show abstract

“…Even though the intraarticular disc in most of these joints must be expected to be severely changed and unable to prevent the clavicular head from superior motion during lifting, the enlargement of the head, related to the degenerative condition, might pull the interclavicular ligament superiorly, resulting in a tightening of the ligament. This could explain why the clavicular head in this situation is not subluxating superiorly during depression of the shoulder[19]. …”

Section: Discussionmentioning

confidence: 99%

Possibilities for arthroscopic treatment of the ageing sternoclavicular joint

Rathcke

Tranum‐Jensen

Krogsgaard

2017

WJO

View full text Add to dashboard Cite

AIMTo investigate if there are typical degenerative changes in the ageing sternoclavicular joint (SCJ), potentially accessible for arthroscopic intervention.METHODSBoth SCJs were obtained from 39 human cadavers (mean age: 79 years, range: 59-96, 13 F/26 M). Each frozen specimen was divided frontally with a band saw, so that both SCJs were opened in the same section through the center of the discs. After thawing of the specimens, the condition of the discs was evaluated by probing and visual inspection. The articular cartilages were graded according to Outerbridge, and disc attachments were probed. Cranio-caudal heights of the joint cartilages were measured. Superior motion of the clavicle with inferior movement of the lateral clavicle was measured.RESULTSDegenerative changes of the discs were common. Only 22 discs (28%) were fully attached and the discs were thickest superiorly. We found a typical pattern: Detachment of the disc inferiorly in connection with thinning, fraying and fragmentation of the inferior part of the disc, and detachment from the anterior and/or posterior capsule. Severe joint cartilage degeneration ≥ grade 3 was more common on the clavicular side (73%) than on the sternal side (54%) of the joint. In cadavers < 70 years 75% had ≤ grade 2 changes while this was the case for only 19% aged 90 years or more. There was no difference in cartilage changes when right and left sides were compared, and no difference between sexes. Only one cadaver - a woman aged 60 years - had normal cartilages.CONCLUSIONChanges in the disc and cartilages can be treated by resection of disc, cartilage, intraarticular osteophytes or medial clavicle end. Reattachment of a degenerated disc is not possible.

show abstract

Relationship of the Medial Clavicular Head to the Manubrium in Normal and Symptomatic Degenerated Sternoclavicular Joints

Cited by 8 publications

References 24 publications

Diagnostic value of active protraction and retraction for sternoclavicular joint pain

Diagnostic value of active protraction and retraction for sternoclavicular joint pain

Minimum 5-Year Outcomes and Return to Sports After Resection Arthroplasty for the Treatment of Sternoclavicular Osteoarthritis

Possibilities for arthroscopic treatment of the ageing sternoclavicular joint

Contact Info

Product

Resources

About