Rehabilitation Following Sternoclavicular Joint Reconstruction for Persistent Instability

Logan, Catherine; Shahien, Amir; Altıntaş, Burak; Millett, Peter J.

doi:10.26603/ijspt20180752

Cited by 11 publications

(7 citation statements)

References 41 publications

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“…Then, we made two holes with a drill about 1cm away from the end, allowing the needle to pass through with the tape [Figure 5]. [14] We elevated the periosteum and tissue attached to the sternum to allow a good view of the articular notch. We also made two holes in the sternum to allow passage of a sharp cutting needle of the tape suture.…”

Section: Surgical Techniquementioning

confidence: 99%

Is reconstructing anterior sternoclavicular joint dislocation by a high-strength tape suture a good choice?

Ibrahim

Elsherbiny

Farag

et al. 2023

JMSR

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Objectives: Sternoclavicular joint (SCJ) dislocation is uncommon but dangerous. Redislocation frequently occurs after manual reduction due to the torn ligaments of the joint with a high-energy injury, which is often the case. Reconstruction of the SCJ is recommended to avoid poor efficacy of conservative treatment and decreasing quality of life in the patient due to progressive pain limiting the movement of the shoulder girdle. Our study aimed to evaluate the efficacy, safety, and patient satisfaction using a high-strength non-absorbable tape suture to reconstruct the anterior SCJ dislocation. Methods: This study included ten patients (Nine males and one female) who presented with acute anterior dislocation of the SCJ (six on the right and four on the left side). Our patients’ average age was 40.1 years (18–52 years), with 12 months on average follow-up (9–18 months). Four patients had isolated anterior SCJ dislocation, while the others had associated injuries. Results: All patients had excellent functional and satisfactory outcomes and returned to the pre-injury activity level. No intraoperative or major post-operative complications were recorded, and no injuries to near structures or wound problems were noted. The mean improvement of physical function measured by the American shoulder and elbow score was 24.59, which increased from 68.11 ± 3.72 preoperatively to 92.70 ± 3.54 postoperatively. Conclusion: The technique of open reconstruction of anterior SCJ dislocation using high-strength nonabsorbable tape sutures is recommended because it gave us excellent results regarding the safety, functional outcome, patient satisfaction, and avoidance of other surgical site morbidities.

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Section: Surgical Techniquementioning

confidence: 99%

Is reconstructing anterior sternoclavicular joint dislocation by a high-strength tape suture a good choice?

Ibrahim

Elsherbiny

Farag

et al. 2023

JMSR

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“…Most often, patients suffering an SC joint dislocation or injury present with pain at the SC joint, which increases with most movements of the ipsilateral shoulder girdle. 15 Often patients support the injured arm with the contralateral arm and sometimes will tilt their head to the side of the injury. 9,27 Pain at the SC joint in patients with dislocations often increases when laying supine.…”

Section: Clinical Presentation and Initial Managementmentioning

confidence: 99%

“…Owing to its articular incongruity and lack of osseous constraint, the SC joint has free passive motion in all planes in addition to being able to rotate about the long axis of the clavicle. 15 The SC joint has its greatest range of motion in the anterior-to-posterior plane where it can either protract or retract about 35° in either direction followed by elevation where 30° to 35° of motion can occur. 15 The other major motion of the SC joint is anterior or posterior rotation about the lateral axis of the clavicle.…”

Section: Anatomy and Biomechanicsmentioning

confidence: 99%

“…9,27 Pain at the SC joint in patients with dislocations often increases when laying supine. 15 Because SC joint injuries often occur as part of high-energy polytraumatic injuries, pain may not be initially reported at the SC joint because of distracting injuries or alterations in patient mental status. Inspection of the SC joint can be particularly useful in these situations.…”

Section: Clinical Presentation and Initial Managementmentioning

confidence: 99%

“…Return to sport can occur when patients have no pain with sport-specific exercise, have full, painless range of motion of the surgical extremity, and have strength within 10% of the contralateral extremity. 15…”

Section: Sternoclavicular Joint Reconstructionmentioning

confidence: 99%

See 2 more Smart Citations

Sternoclavicular Joint Instability and Reconstruction

Provencher

Bernholt

Peebles

et al. 2022

J Am Acad Orthop Surg

Self Cite

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Chronic instability or degenerative arthritis of the sternoclavicular (SC) joint may occur after traumatic or spontaneous dislocation of the SC joint. Most commonly, chronic instability of the SC joint occurs anteriorly; however, posterior instability has an increased risk of serious complications because of proximity to mediastinal structures. Although chronic anterior instability of the SC joint does not resolve with nonsurgical treatment, patients often have mild symptoms that do not impair activities of daily living; however, chronic anterior SC joint instability may be functionally limiting in more active individuals. In these cases, surgical treatment with either (1) SC joint reconstruction or (2) medial clavicle resection, or both, can be done. Recurrent posterior instability of the SC joint also requires surgical treatment due to risk of injury to mediastinal structures. Recent literature describes various reconstruction techniques which generally show improved patient-reported outcomes and low complication rates.

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Morphology of the sternoclavicular joint and its microanatomical changes in response to osteoarthritic degeneration

Mok,

Almajed,

Alomiery

et al. 2024

Clinical Anatomy

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Although the sternoclavicular joint shares structural similarities with the knee and hip joints as a diarthrodial joint, its biomechanics differ significantly due to its non‐weight‐bearing nature. Nevertheless, it is subject to considerable loading, leading to increased susceptibility to osteoarthritis, a prevalent condition characterized by the degeneration of the joint's articular surfaces and fibrocartilaginous intra‐articular disc. The osteoarthritic degeneration of the fibrocartilaginous and cartilaginous surfaces of the sternoclavicular joint has been investigated, considering multiple factors. These include cell count, collagen alignment, surface fibrillation, cyst formation, and glycosaminoglycan content, with the findings deemed significant. However, current treatments for osteoarthritis of the sternoclavicular joint tend to focus on symptom management rather than active prevention of disease progression. Therefore, a detailed understanding of the anatomy, biomechanics, and morphological changes of the sternoclavicular joint during all stages of the osteoarthritic disease is essential for effective management to allow for maximum patient outcomes. This review explores the current literature on the anatomy of the sternoclavicular joint, starting with its structure and comparison to surrounding joints, biomechanics, and morphology, before considering the microanatomical changes that occur due to osteoarthritic degeneration. Early identification of osteoarthritic changes within this joint can enhance treatment and management outcomes before advancing joint degeneration, improving the quality of life for those affected.

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Rehabilitation Following Sternoclavicular Joint Reconstruction for Persistent Instability

Cited by 11 publications

References 41 publications

Is reconstructing anterior sternoclavicular joint dislocation by a high-strength tape suture a good choice?

Is reconstructing anterior sternoclavicular joint dislocation by a high-strength tape suture a good choice?

Sternoclavicular Joint Instability and Reconstruction

Morphology of the sternoclavicular joint and its microanatomical changes in response to osteoarthritic degeneration

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