title: Microperforation prolotherapy: a novel method for successful nonsurgical treatment of atraumatic spontaneous anterior sternoclavicular subluxation, with an illustrative case.
abstract: BACKGROUND
  Surgical repair of an atraumatic spontaneous anterior subluxation of the sternoclavicular joint (herein referred to as the "SCJ") is often associated with poor outcome expectations. With traditional treatment, successful conservative therapy usually incorporates major lifestyle alterations. This manuscript discusses a novel approach known as "microperforation prolotherapy". To illustrate the technique, the care of a patient who benefitted from this treatment is reviewed.
  
  
  OBJECTIVE
  To present a novel form of treatment with an illustrative case that demonstrates the potential efficacy of microperforation prolotherapy of the SCJ.
  
  
  METHODS
  A novel approach to treatment of bilateral subluxation of the sternoclavicular joint with microperforation prolotherapy is discussed. The clinical course of a 21-year-old male with bilateral subluxation of the SCJ, which seriously hampered the patient's athletic and daily living activities, is used as a backdrop to the discussion.
  
  
  RESULTS
  Following microperforation prolotherapy, the instability of the SCJ was replaced by full stability, complete range of motion, and the opportunity to engage in all of the athletic endeavors previously pursued. There is no scar or other cosmetic defect resulting from the treatment received.
  
  
  CONCLUSIONS
  Anterior sternoclavicular joint subluxation has a poor record of complete recovery with surgical procedures or conservative measures with regard to providing restoration of full lifestyle function. This manuscript documents a novel microperforation prolotherapy treatment that induced healing and restored full stability to the ligament structures responsible for the condition in a completely safe and effective fashion, allowing the patient to resume full lifestyle activities without restriction. The exceptional response to treatment noted here is encouragement for further studies.
authors.affiliation: Stein Orthopedic Associates, PA, Plantation, FL, USA.
authors.forename: Alvin
authors.initials: A
authors.lastname: Stein
authors.forename: Scott
authors.initials: S
authors.lastname: McAleer
authors.forename: Marty
authors.initials: M
authors.lastname: Hinz
keywords: anterior subluxation; shoulder pain; spontaneous instability; sternoclavicular instability; sternoclavicular joint subluxation