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Minimum 2-Year Outcomes after Resection Arthroplasty of the Sternoclavicular Joint

机译:锁骨关节切除术后至少两年的结局

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Objectives: Injuries of the sternoclavicular (SC) joint are rare and are usually caused by high energy mechanisms, such as collision sports or motor vehicle accidents. The aims of this study were to assess functional outcomes and return to sport following resection arthroplasty for osteoarthritis of the sternoclavicular joint. Methods: 20 SC joints (18 patients) had undergone resection arthroplasty of up to a maximum of 10 mm of the medial end of the clavicle for painful osteoarthritis, without instability, between November 2006 and November 2013. Patients at least two years out from surgery and living in the U.S. were included in the study. This was an IRB-approved retrospective outcomes study with prospectively collected data. Preoperative and postoperative function and pain levels were assessed with the ASES, SF-12 PCS, QuickDASH and SANE scores. Additionally, the level of sport intensity and the pain levels during activities of daily living, work and recreation were assessed pre- and postoperatively. The results of the functional outcome scores were normally distributed and were compared with the paired sample t-test. The results of pain level assessment were not normally distributed and were compared with the paired Wilcoxon signed-rank test. Results: 19 SC joints in 17 patients (9 female, 8 male; mean age at time of surgery 39.5±17.1 years) met inclusion criteria. One patient refused participation in the study. Two patients (10.5%) were considered failures as they required additional SC joint surgery (one patient with revision resection of the medial clavicle for persistent symptoms and one patient with secondary figure-of-eight graft stabilization for instability). Minimum 2-year outcomes data were available for 14 of the remaining 16 SC joints (88%). The mean time to follow-up was 3.1 years (range, 2.0-8.8 years). The ASES score, QuickDASH, and pain levels demonstrated significant improvement postoperatively (p 0.05; Table 1). All patients (100%, n=11) that answered the question were able to return to sport, with 64% of these patients (n=7) returning to their pre-injury level or slightly below. Conclusion: Resection arthroplasty of up to a maximum of 10 mm of the medial end of the clavicle in patients with osteoarthritis of the SC joint results in significant functional improvement, pain reduction, and a high rate of return to sport at mid-term follow-up.
机译:目的:锁骨(SC)关节损伤很少见,通常是由高能机制引起的,例如碰撞运动或机动车事故。这项研究的目的是评估切除手术后的肩锁关节骨关节炎的功能结局和恢复运动。方法:在2006年11月至2013年11月之间,对20例SC关节(18例患者)进行了关节置换手术,以治疗疼痛性骨关节炎且不稳定性的情况下,锁骨内侧末端最多10毫米。患者至少接受了两年手术和居住在美国的情况都纳入了研究。这是一项IRB批准的回顾性结局研究,其中收集了前瞻性数据。术前和术后功能和疼痛程度通过ASES,SF-12 PCS,QuickDASH和SANE评分进行评估。此外,在术前和术后评估运动强度水平以及日常生活,工作和娱乐活动中的疼痛程度。功能结果评分的结果呈正态分布,并与配对样本t检验进行比较。疼痛程度评估的结果并非呈正态分布,而是与配对的Wilcoxon符号秩检验进行比较。结果:17例患者的19个SC关节(女性9例,男性8例;手术时的平均年龄39.5±17.1岁)符合纳入标准。一名患者拒绝参加该研究。两名患者(10.5%)被认为是失败的,因为他们需要进行额外的SC关节手术(一名患者的锁骨内侧切除术是持续性症状,而另一名患者进行了二次八字植体稳定术是不稳定的)。其余16个SC关节中的14个(88%)可获得至少两年的结果数据。平均随访时间为3.1年(范围2.0-8.8年)。术后ASES评分,QuickDASH和疼痛程度均有明显改善(p 0.05;表1)。所有回答该问题的患者(100%,n = 11)都能够恢复运动,其中这些患者中的64%(n = 7)恢复到受伤前水平或略低于受伤水平。结论:SC关节骨关节炎患者的锁骨内侧最大10 mm切除关节置换术可显着改善功能,减轻疼痛,并在中期随访时恢复较高的运动率。向上。

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