Division of Orthopaedics, Addenbrookes Hospital, Cambridge University Hospitals NHS Trust, Cambridge, United Kingdom.
Division of Orthopaedics, Addenbrookes Hospital, Cambridge University Hospitals NHS Trust, Cambridge, United Kingdom.
Arthroscopy. 2020 May;36(5):1223-1229. doi: 10.1016/j.arthro.2019.12.005. Epub 2019 Dec 17.
to report the results of a consecutive series of 50 patients who underwent an arthroscopic excision of the sternoclavicular joint (SCJ) for primary osteoarthritis refractory to conservative treatment.
We undertook an arthroscopic excision of the SCJ in 50 patients with primary osteoarthritis refractory to conservative treatment. This included an adequate course of physiotherapy and at least 1 ultrasound-guided cortisone injection. There were 26 female and 24 male patients and the mean age at the time of surgery was 54.5 years (range 39-72 years). Patients were assessed preoperatively and at final follow-up with the Constant, Rockwood SCJ, and Quick-DASH scores. The mean follow-up was 41.8 months (range 24-73 months). Surgery was undertaken as a day-case with no shoulder immobilization.
Forty-five patients were available at final-follow up. The median Constant score had increased from 55 (range 37-79) to 72 (range 38-92), Rockwood score from 6 (range 4-9) to 13 (range 4-15), and Quick-DASH 36 (range 18-69) to 12 (range 0-51). All of these changes were statistically significant (P < .0001). There were no complications and, specifically, no problems with joint instability. Forty-four of the 45 patients were pleased with the results of their surgery and indicated that they would be happy to have the procedure again.
The results of this study show that arthroscopic excision arthroplasty of the SCJ is a satisfactory treatment for primary SCJ osteoarthritis refractory to conservative treatment.
Level IV case series.
报告 50 例原发性肩锁关节炎患者经关节镜下切除治疗的连续系列结果，这些患者对保守治疗均无反应。
我们对 50 例原发性肩锁关节炎患者进行了关节镜下切除治疗，这些患者对保守治疗均无反应，包括充分的物理治疗和至少 1 次超声引导下皮质类固醇注射。其中 26 例为女性，24 例为男性，手术时的平均年龄为 54.5 岁（范围 39-72 岁）。患者在术前和最终随访时采用 Constant、Rockwood 肩锁关节和 Quick-DASH 评分进行评估。平均随访时间为 41.8 个月（范围 24-73 个月）。手术为日间手术，不进行肩部固定。
45 例患者在最终随访时可评估。中位数 Constant 评分从 55（范围 37-79）增加到 72（范围 38-92），Rockwood 评分从 6（范围 4-9）增加到 13（范围 4-15），Quick-DASH 评分从 36（范围 18-69）减少到 12（范围 0-51）。所有这些变化均具有统计学意义（P<0.0001）。无并发症发生，特别是无关节不稳定问题。45 例患者中的 44 例对手术结果表示满意，并表示愿意再次接受该手术。
本研究结果表明，关节镜下切除肩锁关节是治疗原发性肩锁关节炎的一种满意方法，这些患者对保守治疗无反应。
IV 级病例系列。
