BACKGROUND: Chronic symptomatic anterior sternoclavicular (SC) instability is a rare condition with sparse treatment options. Owing to the rarity of the condition and the potential risk of fatal complications, only a few reports on treatment of this condition have been published. We evaluated a prospective series of patients with chronic anterior SC instability who underwent minimally open reconstruction with an autologous tendon graft. METHODS: From 2002 to 2010, 32 consecutive patients underwent minimally open SC ligament reconstruction using a tendon autograft. A palmaris longus was used in 7 patients and a gracilis tendon autograft was used in 25. All patients with at least 2 years of follow-up were reviewed. Five were lost to follow-up. The remaining 27 patients (84.4%) were a median age of 35 years (range, 11-61 years) at surgery. Patients were evaluated with the Western Ontario Shoulder Instability (WOSI) score preoperatively and at follow-up at a median 54 months (range, 24-120 months) postoperatively. RESULTS: The total WOSI score improved from a median of 44% (range 6%-62%) preoperatively to 75% (range, 13%-93%) at follow-up (P = .0001). Two failures (7.4%) occurred; after revision, both patients remained stable. After the operation, 17 of 25 patients (68%) complained of donor site morbidity, and 10 (40%) still had some discomfort at follow-up. No infections or local vascular complications occurred. CONCLUSIONS: Miniopen SC joint reconstruction using a tendon autograft results in prolonged improvement in shoulder function in most patients with symptomatic anterior SC instability.
BACKGROUND: Chronic symptomatic anterior sternoclavicular (SC) instability is a rare condition with sparse treatment options. Owing to the rarity of the condition and the potential risk of fatal complications, only a few reports on treatment of this condition have been published. We evaluated a prospective series of patients with chronic anterior SC instability who underwent minimally open reconstruction with an autologous tendon graft. METHODS: From 2002 to 2010, 32 consecutive patients underwent minimally open SC ligament reconstruction using a tendon autograft. A palmaris longus was used in 7 patients and a gracilis tendon autograft was used in 25. All patients with at least 2 years of follow-up were reviewed. Five were lost to follow-up. The remaining 27 patients (84.4%) were a median age of 35 years (range, 11-61 years) at surgery. Patients were evaluated with the Western Ontario Shoulder Instability (WOSI) score preoperatively and at follow-up at a median 54 months (range, 24-120 months) postoperatively. RESULTS: The total WOSI score improved from a median of 44% (range 6%-62%) preoperatively to 75% (range, 13%-93%) at follow-up (P = .0001). Two failures (7.4%) occurred; after revision, both patients remained stable. After the operation, 17 of 25 patients (68%) complained of donor site morbidity, and 10 (40%) still had some discomfort at follow-up. No infections or local vascular complications occurred. CONCLUSIONS: Miniopen SC joint reconstruction using a tendon autograft results in prolonged improvement in shoulder function in most patients with symptomatic anterior SC instability.
Authors: Frank Martetschläger; Sepp Braun; Stephan Lorenz; Andreas Lenich; Andreas B Imhoff Journal: Knee Surg Sports Traumatol Arthrosc Date: 2015-03-11 Impact factor: 4.342
Authors: Lukas Willinger; Jakob Schanda; Elmar Herbst; Andreas B Imhoff; Frank Martetschläger Journal: Knee Surg Sports Traumatol Arthrosc Date: 2015-09-03 Impact factor: 4.342
Authors: Bernardo Barcellos Terra; Leandro Marano Rodrigues; David Victoria Hoffmann Pádua; Marcelo Giovanini Martins; João Carlos de Medeiros Teixeira; Anderson De Nadai Journal: Rev Bras Ortop Date: 2015-07-10
Authors: Just A van der Linde; W Jaap Willems; Derk A van Kampen; Loes W A H van Beers; Derek F P van Deurzen; Caroline B Terwee Journal: BMC Musculoskelet Disord Date: 2014-06-20 Impact factor: 2.362