title: Clinical outcomes after autograft reconstruction for sternoclavicular joint instability.
abstract: BACKGROUND
  Instability of the sternoclavicular (SC) joint is a rare condition. However, in some cases, SC joint instability may lead to persistent pain and impairment of shoulder function that requires surgical management. This study evaluated clinical outcomes after SC joint reconstruction with hamstring tendon autograft in patients with SC joint instability.
  
  
  METHODS
  From December 2010 to January 2014, 21 reconstructions of the SC joint with hamstring tendon autograft were performed. Outcomes data were prospectively collected and retrospectively reviewed. Data analyzed included American Shoulder and Elbow Surgeons score, Quick Disability of the Arm, Shoulder and Hand, physical component of the Short Form 12, and Single Assessment Numeric Evaluation scores. Pain with activities of daily living, work, and sleep were separately analyzed along with painless use of arm for activities. Patients were also questioned regarding postoperative satisfaction.
  
  
  RESULTS
  Nine women and 10 men (2 bilaterals), with a mean age of 30 years (range, 15-56 years), were monitored for a mean of 2 years (range, 12-36 months) postoperatively. Mean American Shoulder and Elbow Surgeons, Quick Disability of the Arm, Shoulder and Hand, and Single Assessment Numeric Evaluation scores significantly improved (P < .001). Pain scores also improved over preoperative baselines, including pain with activities of daily living, work, and sleep (P < .001). Median satisfaction at final follow-up was 8.5 (range, 7-10). There were no intraoperative or postoperative complications and no cases of recurrent instability.
  
  
  CONCLUSIONS
  Free hamstring tendon autograft reconstruction for SC joint instability resulted in significantly improved clinical outcomes with high patient satisfaction and no intraoperative or postoperative complications.
authors.affiliation: The Steadman Philippon Research Institute, Vail, CO, USA; The Steadman Clinic, Vail, CO, USA.
authors.forename: Maximilian
authors.initials: M
authors.lastname: Petri
authors.affiliation: The Steadman Philippon Research Institute, Vail, CO, USA.
authors.forename: Joshua A
authors.initials: JA
authors.lastname: Greenspoon
authors.affiliation: The Steadman Philippon Research Institute, Vail, CO, USA.
authors.forename: Marilee P
authors.initials: MP
authors.lastname: Horan
authors.affiliation: The Steadman Philippon Research Institute, Vail, CO, USA; The Steadman Clinic, Vail, CO, USA; Department of Shoulder and Elbow Surgery, ATOS Clinic Munich, Munich, Germany; Department of Orthopaedic Sports Medicine, Clinic rechts der Isar, Technical University Munich, Munich, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Martetschläger
authors.affiliation: The Steadman Philippon Research Institute, Vail, CO, USA.
authors.forename: Ryan J
authors.initials: RJ
authors.lastname: Warth
authors.affiliation: The Steadman Philippon Research Institute, Vail, CO, USA; The Steadman Clinic, Vail, CO, USA. Electronic address: drmillett@thesteadmanclinic.com.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Millett
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011184:Postoperative Period; D012189:Retrospective Studies; D020069:Shoulder Pain / Q000209:etiology*; D013247:Sternoclavicular Joint / Q000601:surgery*; D013710:Tendons / Q000637:transplantation; D014182:Transplantation, Autologous; D055815:Young Adult
keywords: SC; Sternoclavicular joint; autograft; instability; reconstruction