Possibilities for arthroscopic treatment of the ageing sternoclavicular joint
Possibilities for arthroscopic treatment of the ageing sternoclavicular joint作者机构：Section for Sportstraumatology M51 Bispebjerg-Frederiksberg Hospital Department of Cellular and Molecular Medicine University of Copenhagen
出 版 物：《World Journal of Orthopedics》 (世界骨科杂志（英文版）)
年 卷 期：2017年第8卷第7期
页 面：536-544页
学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学]
主 题：Sternoclavicular Degenerative Cartilage Disc Arthroscopy
摘 要：AIM To investigate if there are typical degenerative changes in the ageing sternoclavicular joint(SCJ), potentially accessible for arthroscopic *** Both SCJs were obtained from 39 human cadavers(mean age: 79 years, range: 59-96, 13 F/26 M). Each frozen specimen was divided frontally with a band saw, so that both SCJs were opened in the same section through the center of the discs. After thawing of the specimens, the condition of the discs was evaluated by probing and visual inspection. The articular cartilages were graded according to Outerbridge, and disc attachments were probed. Cranio-caudal heights of the joint cartilages were measured. Superior motion of the clavicle with inferior movement of the lateral clavicle was *** Degenerative changes of the discs were common. Only 22 discs(28%) were fully attached and the discs were thickest superiorly. We found a typical pattern: Detachment of the disc inferiorly in connection with thinning, fraying and fragmentation of the inferior part of the disc, and detachment from the anterior and/or posterior capsule. Severe joint cartilage degeneration ≥ grade 3 was more common on the clavicular side(73%) than on the sternal side(54%) of the joint. In cadavers 70 years 75% had ≤ grade 2 changes while this was the case for only 19% aged 90 years or more. There was no difference in cartilage changes when right and left sides were compared, and no difference between sexes. Only one cadaver-a woman aged 60 years-had normal cartilages. CONCLUSION Changes in the disc and cartilages can be treated by resection of disc, cartilage, intraarticular osteophytes or medial clavicle end. Reattachment of a degenerated disc is not possible.
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