Outcomes of augmented allograft figure-of-eight sternoclavicular joint reconstruction

Jefferson B Sabatini; Joseph R Shung; T Bradly Clay; Lasun O Oladeji; Douglas J Minnich; Brent A Ponce

doi:10.1016/j.jse.2014.10.001

Outcomes of augmented allograft figure-of-eight sternoclavicular joint reconstruction

J Shoulder Elbow Surg. 2015 Jun;24(6):902-7. doi: 10.1016/j.jse.2014.10.001. Epub 2014 Dec 3.

Authors

Jefferson B Sabatini¹, Joseph R Shung¹, T Bradly Clay², Lasun O Oladeji³, Douglas J Minnich⁴, Brent A Ponce⁵

Affiliations

¹ Division of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
² Department of Orthopaedics and Rehabilitation, University of Florida, Gainesville, FL, USA.
³ University of Illinois College of Medicine at Peoria (UICOMP), Peoria, IL, USA.
⁴ Division of Cardiothoracic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
⁵ Division of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL, USA. Electronic address: [email protected].

PMID: 25487906
DOI: 10.1016/j.jse.2014.10.001

Abstract

Background: Sternoclavicular joint (SCJ) instability is a rare condition resulting in impaired function and shoulder girdle pain. Various methods for stabilizing the SCJ have been proposed, with biomechanical analysis demonstrating superior stiffness and peak load properties with a figure-of-8 tendon graft technique. The purpose of this study was to evaluate the clinical outcomes of SCJ reconstruction with an interference screw figure-of-8 allograft tendon technique.

Methods: A retrospective analysis of a consecutive cohort of patients from 2007 to 2011 was performed for all patients undergoing SCJ reconstruction for instability. All patients were treated for SCJ instability with a figure-of-8 allograft reconstruction augmented by 2 tenodesis screws. Outcomes were performed with the American Shoulder and Elbow Surgeons (ASES) score, the shortened Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score, and the visual analog scale (VAS) for pain score for all patients. Intraoperative and postoperative complications were recorded.

Results: A total of 10 patients were included in the study, with an average follow-up of 38 months (range, 11.6-66.8 months). Preoperatively, the mean ASES score was 35.3 points (range, 21.7-55 points), whereas the postoperative mean ASES score increased to 84.7 points (range, 66.6-95 points). The mean VAS score improved from 7.0 (range, 5-10) before surgery to 1.15 (range, 0-3) at follow-up, and the QuickDASH score average was 17.0 points (range, 0 to 38.6 points). Minor postoperative complications were noted in 2 patients.

Conclusion: Patients who underwent repair of SCJ instability by an augmented figure-of-8 allograft tendon reconstruction report marked improvements in both shoulder function and pain relief.

Keywords: Sternoclavicular joint; interference screw; sternoclavicular joint dislocation; sternoclavicular joint instability; sternoclavicular joint reconstruction.

MeSH terms

Adolescent
Adult
Allografts
Arthroplasty / methods*
Female
Follow-Up Studies
Humans
Joint Instability / complications
Joint Instability / surgery*
Male
Middle Aged
Pain Measurement
Retrospective Studies
Shoulder Pain / etiology
Sternoclavicular Joint / physiopathology
Sternoclavicular Joint / surgery*
Tendons / transplantation*
Tenodesis
Young Adult