Experience with arthroscopic treatment of disorders in the sternoclavicular joint: A prospective series of 78 patients

PURPOSE: To evaluate pain, function and patient-reported outcomes following arthroscopically intended treatment of painful sternoclavicular joint (SCJ) conditions between 2010 and 2024 in a consecutive cohort with long-term follow-up including 78 patients. We hypothesised that this procedure would reduce pain and improve function, even when conversion to open surgery was required.

METHODS: Seventy-eight patients with SCJ pain unresponsive to ≥12 months of conservative therapy were scheduled for arthroscopic surgery. Outcomes were assessed using the Disabilities of the Arm, Shoulder and Hand (DASH) score and the Oxford Shoulder Score (OSS). Follow-up included assessments at 1, 2 and 5 years, as well as a final cross-sectional evaluation (mean 7.2 years), capturing function, work ability, sports participation and satisfaction.

RESULTS: In 24 patients, the procedure was converted to open surgery, primarily due to obstructing osteophytes, insufficient visualisation, or narrow joint space. Sixty-four patients (82%) completed long-term follow-up. Significant improvements were observed in DASH (61.8 ± 19.2 to 16.1 ± 18.0; p < 0.00001) and OSS pain sub-scores for worst pain (2.65 ± 0.9 to 1.1 ± 1.0; p < 0.00001). Five patients (6%) underwent reoperation. Sports-related limitations improved from 75.9% preoperatively to 15.6% postoperatively. At final follow-up, 87% reported complete or partial symptom resolution, and 90% would choose surgery again.

CONCLUSIONS: Arthroscopically intended SCJ treatment provides significant and sustained improvements in pain and function. Although conversion to open surgery was required in approximately one-third of cases, overall outcomes were favourable, with high satisfaction and low complication and reoperation rates.

LEVEL OF EVIDENCE: Level IV.