Interposition arthroplasty with meniscal allograft for the treatment of sternoclavicular joint pathology: the SC calamari technique.

Abstract

Painful degeneration of the sternoclavicular joint refractory to nonoperative treatment has historically been managed with resection of the degenerative segment of the medial clavicle. Although this has produced good results with improvement in symptoms, recurrent pain necessitating revision surgery is not an infrequently encountered outcome. To reduce the occurrence of recurrent postoperative pain, a novel technique to reconstruct the intra-articular disc at the time of medial clavicle resection was developed. Ten patients who underwent medial clavicle excision and interposition arthroplasty with a lateral meniscus allograft were retrospectively reviewed. Functional results were based on visual analog scale pain scores and subjective shoulder value scores. Visual analog scale pain score improved from 7.5 (5-10) preoperatively to 1.2 (0-2; P = .005, W value = 0) postoperatively, with an average improvement of 6.3. The mean preoperative subjective shoulder value score improved from 54.5% (25%-70%) preoperatively to 88.5% (80%-95%; P = .005; W value = 0) postoperatively, with a mean increase of 34 percentage points. No patients experienced a complication and/or recurrence of pain at the most recent follow-up. Minimal excision of the medial clavicle and interposition arthroplasty with lateral meniscal allograft successfully reduces pain and restores stability and function for the treatment of painful degeneration of the sternoclavicular joint.