Sternoclavicular Joint Arthritis: Arthroscopic and Open Resection

Symptomatic sternoclavicular joint arthritis is relatively uncommon. Most patients can be treated successfully by nonoperative measures. However, in a few patients, despite adequate nonoperative treatment, symptoms persist. Open excision arthroplasty and, more recently, an arthroscopic technique have been described for the management of resistant cases. In this article, the anatomy and pathophysiology of sternoclavicular (SC) joint arthritis have been described. The operative techniques and results of open excision arthroplasty are reviewed. The clinical results of most series are good, although the case numbers are low. This may be partly owing to a relative reluctance to undergo surgery because of concerns of potential damage to posterior mediastinal vascular structures. The results for arthroscopic SC excision arthroplasty and the operative technique are described. The clinical results for the arthroscopic technique are comparable to those of the open series but with less perioperative morbidity. Excision arthroplasty for patients with SC arthritis resistant to nonoperative measures is only considered rarely. However, the results for open and arthroscopic excision arthroplasty, although from relatively small series, appear to be consistently good.