Arthroscopic Sternoclavicular Joint Resection Arthroplasty: A Technical Note and Illustrated Case Report

Symptomatic osteoarthritis of the sternoclavicular (SC) joint is an uncommon pathology that can produce significant pain and disability in some patients. Although conservative management typically results in symptomatic improvement, a small subset of patients will have recalcitrant pain and continued shoulder disability. Surgical management is therefore indicated after a course of nonoperative therapy fails to provide symptomatic relief.

Traditionally, open resection arthroplasty of the SC joint has been the treatment of choice in patients with intractable pain and dysfunction as a result of SC joint osteoarthritis. Good to excellent outcomes have been reported after open resection arthroplasty in several series1-3; however, an open approach to the SC joint requires some posterior dissection, potentially placing vital mediastinal structures at risk. In addition, over- resection of the medial clavicle with a large capsulotomy may lead to postoperative instability because of the need for intraoperative ligament detachment.

As reported by Tavakkolizadeh, arthroscopy of the SC joint was originally thought to enhance patient outcomes by improving visualization, minimizing surgical trauma, limiting the risk to vital retrosternal structures, avoiding postoperative instability, and hastening recovery times while also improving cosmesis. Because of these advantages and with the addition of new encouraging outcomes data, SC joint arthroscopy has become a viable and, potentially, favorable modality for the treatment of symptomatic SC joint osteoarthritis in carefully selected patients. However, very few orthopaedic surgeons or arthroscopists have experience with the technique.

Therefore the purposes of this article are (1) to describe pertinent arthroscopic anatomy related to the SC joint, (2) to present and demonstrate a technique for arthroscopic SC joint resection arthroplasty, and (3) to illustrate a case in which bilateral SC joint decompressions were necessary in a young, active patient with symptomatic degenerative osteoarthritis of the SC joint.

Full Article: Arthroscopic Sternoclavicular Joint Resection Arthroplasty: A Technical Note and Illustrated Case Report

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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Arthroscopic Sternoclavicular Joint Resection Arthroplasty: A Technical Note and Illustrated Case Report

About the Author: Peter Millett, MD