title: Resection arthroplasty for septic arthritis of the sternoclavicular joint.
abstract: BACKGROUND
  Treatment for septic arthritis of the sternoclavicular (SC) joint with concomitant osteomyelitis of the clavicle often requires joint resection rather than simple incision and drainage. We evaluated the effectiveness of resection arthroplasty for patients with septic arthritis of the SC joint.
  
  
  METHODS
  We retrospectively reviewed 10 patients who underwent resection arthroplasty for SC joint septic arthritis between 1996 and 2008. The mean patient age was 52.8 ± 10.5 years (range, 40-72 years), the mean symptom duration before surgery was 16.9 days (range, 2-60 days), and the mean follow-up period was 35.4 ± 42.2 months (range, 10-108 months). Diagnoses were based on physical examination, laboratory tests, and radiologic studies including magnetic resonance imaging. Each patient had concomitant osteomyelitis of the clavicle. In addition, 4 patients had mediastinitis and 1 had osteomyelitis of the adjacent ribs. All patients underwent SC joint resection and intramedullary ligament reconstruction, followed by intravenous antibiotics for 4 to 8 weeks. Intraoperative cultures were positive in 6 patients.
  
  
  RESULTS
  All infections resolved, with only 1 patient having complications-systemic sepsis and pneumonia. The mean ranges of motion were 146° of forward flexion (range, 135°-155°) and 48° of external rotation (range, 40°-55°), with the internal rotation level ranging from T5 to L3. The mean superior migration of the clavicle was 1.5 mm (range, 0-4 mm), and the mean visual analog pain score was 1.4 ± 0.7 (range, 0-2).
  
  
  CONCLUSIONS
  Resection arthroplasty in patients with septic SC joints results in relatively good shoulder function.
authors.affiliation: Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
authors.forename: Jae Myeung
authors.initials: JM
authors.lastname: Chun
authors.forename: Jin Sam
authors.initials: JS
authors.lastname: Kim
authors.forename: Hong Jun
authors.initials: HJ
authors.lastname: Jung
authors.forename: Jae Bum
authors.initials: JB
authors.lastname: Park
authors.forename: Jung Suk
authors.initials: JS
authors.lastname: Song
authors.forename: Soo-Sung
authors.initials: SS
authors.lastname: Park
authors.forename: Ho Seong
authors.initials: HS
authors.lastname: Lee
authors.forename: Tae Soo
authors.initials: TS
authors.lastname: Ahn
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001170:Arthritis, Infectious / Q000382:microbiology / Q000601:surgery*; D001178:Arthroplasty / Q000009:adverse effects / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011182:Postoperative Care / Q000379:methods; D016059:Range of Motion, Articular / Q000502:physiology*; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D013247:Sternoclavicular Joint / Q000473:pathology* / Q000601:surgery*; D016896:Treatment Outcome