2025 ISAKOS Biennial Congress Paper
Clinical Outcomes After Sternoclavicular Joint Stabilization in a Figure 8 Configuration: The Impact of Biologic Augmentation Within the Repair Construct
Lorenz Fritsch, MD, Munich GERMANY
Marco-Christopher Rupp, MD, Munich, Bavaria GERMANY
Lucca Lacheta, MD, München GERMANY
Bastian Scheiderer, MD, Munich, Bavaria GERMANY
Maximilian Hinz, MD, Munich GERMANY
Sebastian Siebenlist, MD, MHBA, Prof., Munich, Bavaria GERMANY
Department of Sports Orthopaedics, Technical University of Munich, Munich, Germany., Munich, Bavaria, GERMANY
FDA Status Cleared
Summary
Autologous augmentation leads to superior stability in terms of failure in terms of isolated suture tape reconstruction
Abstract
Purpose
The purpose of the study was to report on the functional outcome following sternoclavicular joint (SCJ) reconstruction for SCJ instability using either an isolated tape fixation or a hamstring graft reconstruction with or without suture tape augmentation. It was hypothesized that both types of stabilization of the SCJ lead to favorable clinical outcome and high patient satisfaction. However, it was also hypothesized that graft augmentation is superior to the isolated tape fixation.
Material And Methods
Consecutive patients that underwent SCJ stabilization in a figure-of-8 with augmentation with either suture tape or hamstring tendon for SCJ instability between 07/2013 and 04/2021 were included (minimum follow-up: 24 months). Patient-reported outcome measures (PROs) including Visual Analogue Scale fpr pain (VAS), ASES score, SANE and Nottingham Clavicle Score (NCS) and satisfaction with the postoperative results (global rating of change) were evaluated at a of minimum 24 months postoperatively. Subgroup analysis was performed comparing PROMs between the isolated suture tape cohort and the graft augmentation cohort. Additionally, a custom-made questionnaire including questions regarding reoperation, redislocation, and subluxation was obtained.
Results
Of a total of 33 patients, 29 patients (87,8%) were available for inclusion in the final analysis survey (53.6% male; age 23.5 years (19.3-51.5). In 50.0% (n=14) of patients a SCJ-stabilization was preformed using suture tape only, while in 21.4% (n= 6) surgery was performed with hamstring graft augmentation and in 28.6% (n=8) both augments were combined. At follow-up (50.0 (28.8-69.5) months), patients reported little pain (1 (0-3)) and reached 83.0 points (62.0-99.5) in the ASES score, 82.5 (61.3-95.0) in the SANE and 70.6 ± 20.3 points in the NCS. Mean patient satisfaction was 6.0 of 7.0 points (5.0-6.8). Revision rate was 0% in this cohort at time of FU. The patient reported redislocation rate was 7.1% (n=2), with patient reported subluxation occuring in 14.3% (n=4) of all cases. No statistically significant difference in PROMs including postoperative pain was observed in the patient cohorts reconstructed with tape only vs. those with hamstring graft (p>0.05). Redislocation rate was reported in 15.4% (n=2) of cases with isolated tape stabilization vs. no reoccurring dislocations in constructs including a hamstring autograft (p=0.2), while subluxation rate was 14.2% (n=2) and 14.2% (n=2) (p>0.99), respectively.
Conclusion
Patient undergoing SCJ stabilization achieved favorable clinical results and a high patient satisfaction at short-to midterm follow-up. Results did not significantly differ depending on the material chosen for the reconstruction construct, however there was a tendency towards as lower patient-reported redislocation rate in patients undergoing reconstruction with constructs including hamstring autograft, highlighting the impact of biologic augmentation.