Biomechanical Comparison of Surgical Techniques for Resection Arthroplasty of the Sternoclavicular Joint

Injuries of the sternoclavicular (SC) joint are rare and are usually caused by high-energy impacts experienced during sports or motor vehicle accidents. Symptomatic instability of the SC joint is best treated with surgical reconstruction. Painful posttraumatic osteoarthritis and degenerative conditions of the SC joint without instability can be successfully treated with resection arthroplasty. Discectomy in the early stages after a traumatic disc tear is a treatment option for patients with ongoing posttraumatic joint pain.

Diverse techniques of SC joint resection arthroplasty have been published, with varying amounts of medial clavicle resection ranging from a few millimeters up to 4 cm. A frequently used resection line runs oblique in relation to the SC joint from superolateral to inferomedial. Recently published arthroscopic SC joint resection techniques decompressed the SC joint with discectomy and resection of 6 to 10 mm of the medial end of the clavicle parallel to the joint line. Independent of the resection technique, most authors agree that preservation of ligamentous joint stability is essential for successful outcomes. Current anatomic and biomechanical stud- ies have suggested that minimizing bony resection may be advantageous for preservation of the joint stabilizers. Furthermore, it was observed that only the anteroinferior end of the medial clavicle is covered by articular cartilage and that the appearance and shape of the articular disc vary among patients. The authors of a recent anatomic investigation concluded that further studies are needed regarding the location and extent of medial clavicle resection necessary to adequately decompress the joint and maintain stability.

Therefore, the purpose of this study was to evaluate (1) if resection of the intra-articular disc alone can reliably decompress the SC joint and (2) if resection of the medial end of the clavicle parallel to the joint line decompresses the SC joint similar to the oblique resection technique. We hypothesized that resection of the intra-articular disc alone would not reliably decompress the SC joint and that the parallel joint-line resection technique would decompress the SC joint significantly more compared with the same amount of resection using the oblique technique.

Full Article: Biomechanical Comparison of Surgical Techniques for Resection Arthroplasty of the Sternoclavicular Joint

Peter Millett, MD

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39 reviews

Alexandra Thompson

Mar 23, 2024

by Alexandra Thompson on Peter Millett, MD

110%

Dr. Millett and his team did a SLAP tear repair and bicep tenodesis on my left shoulder. I use my arms as an artist, and love to swim in the ocean, surf, paddle, and telemark ski. So regaining full use of my shoulder and keeping my bicep attached was very important to me. Now, over two years later, my shoulder has the equivalent range of motion as my other arm and as before the injury, and no pain. After the first three months it felt so good and was so strong that - to my horror - I completely forgot my six-month follow-up.

Not only did Dr. Millett and his team make my arm as good as new, but having had the experience of such kindness and expertise throughout the process of surgery and recovery is like an added shoulder superpower.

Thank you Rita, Brooke, Jason, Sarah, Camille, Olivia, Dr. Millett and everyone! And see you soon when my husband comes in for his knee...

Jeff Chandler

Jan 31, 2022

by Jeff Chandler on Peter Millett, MD

Flawless procedure, Easy recovery

Dr. Millet's repaired my knee and tibia, following a botched operation by a different surgeon. That procedure was virtually pain free and I was weight bearing within a few days. That was 18 years ago and the knee is still strong. A few years after the knee incident, Dr Millet repaired my shoulder. My insurance company approved me for 3 months of disability following that surgery. I was off pain medication in 2 days and had 90% range of motion within a week. I withdrew my disability claim and returned to work within two weeks of surgery. I’m not a famous athlete—just a regular guy. Nonetheless, I was treated like an NFL at the Steadman clinic. Most notable was the time for recovery. Other surgeons perform their hour-long task in the OR and don’t involve themselves in the other functions. Peter and his team manages the entire process from diagnosis, anesthesia, nursing care, and therapy. He takes a holistic approach to patient care and doesn’t skip any steps.

Jenn West

Jul 2, 2021

by Jenn West on Peter Millett, MD

Saved My Life

I went to Dr. Millett after 7 knee surgeries (6 on my right and 1 on my left) and had seen 11 different surgeons who all refused to remove femur metal from my right leg. I am highly allergic to metal and the chronic pain was leaving me bedridden for 3.5wks out of a month. He personally wrote me back on my inquiry, listened to my concerns, scheduled my surgery within a week (due to insurance issues) and personally followed up with my recovery. The level of patient care from Dr. Millett and his ENTIRE team is above any care I have ever received in my 20 years of dealing with orthopedic surgeons. There are not enough words to describe the level of care, dedication and professionalism you receive from Dr. Millett and his staff.
My only disappointment is that I did not find him sooner!!!

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Biomechanical Comparison of Surgical Techniques for Resection Arthroplasty of the Sternoclavicular Joint

About the Author: Peter Millett, MD