Division of Orthopaedics, Addenbrooke's Hospital, Cambridge University Teaching Hospital Trust, Hills Road, Cambridge, England.
Arthroscopy. 2013 Sep;29(9):1487-91. doi: 10.1016/j.arthro.2013.05.029. Epub 2013 Jul 30.
To report the results of a series of 10 patients who underwent an arthroscopic excision of the sternoclavicular joint (SCJ) for osteoarthritis refractory to conservative treatment.
We undertook an arthroscopic excision of the SCJ in 10 patients with osteoarthritis. There were 7 female and 3 male patients with a mean age at surgery of 53 years (range, 42 to 62 years). Patients were assessed preoperatively and at follow-up with the Constant score and the Rockwood SCJ scoring system. The mean follow-up was 28 months (range, 17 to 41 months; SD, 8.1 months). Surgery was undertaken as a day case with no shoulder immobilization.
All of the patients had regained their preoperative or full range of movement within 2 weeks of surgery. At most recent follow-up, 7 patients had no pain and 3 had slight pain with activity. The median Constant score had increased from 64.5 (range, 41 to 77) to 83 (range, 61 to 95), and the median Rockwood score had increased from 6 (range, 4 to 7) to 13.5 (range, 9 to 15) (maximum, 15). On the basis of these findings, the clinical results were rated as excellent (13 to 15) in 7 patients, good (10 to 12) in 2, and fair (7 to 9) in 1. There were no complications and, specifically, no problems with joint stability.
The results of this study show that arthroscopic SCJ excision is a satisfactory treatment for SCJ osteoarthritis refractory to conservative measures.
Level IV, therapeutic case series.
报告 10 例接受关节镜下胸锁关节 (SCJ) 切除治疗保守治疗无效的骨关节炎患者的结果。
我们对 10 例骨关节炎患者进行了关节镜下 SCJ 切除。7 例为女性，3 例为男性，手术时平均年龄为 53 岁（范围，42 至 62 岁）。患者在术前和随访时采用 Constant 评分和 Rockwood SCJ 评分系统进行评估。平均随访时间为 28 个月（范围，17 至 41 个月；标准差，8.1 个月）。手术作为日间病例进行，不进行肩部固定。
所有患者均在术后 2 周内恢复术前或完全活动范围。在最近的随访中，7 例患者无疼痛，3 例活动时稍有疼痛。中位数 Constant 评分为 64.5（范围，41 至 77）增加至 83（范围，61 至 95），中位数 Rockwood 评分为 6（范围，4 至 7）增加至 13.5（范围，9 至 15）（最大值，15）。根据这些发现，7 例患者的临床结果评为优（13 至 15），2 例评为良（10 至 12），1 例评为可（7 至 9）。无并发症，特别是无关节稳定性问题。
本研究结果表明，关节镜下 SCJ 切除是治疗保守治疗无效的 SCJ 骨关节炎的一种满意治疗方法。
IV 级，治疗性病例系列。
