Sternoclavicular joint reconstruction for traumatic acute and chronic anterior and posterior instability: Patient-reported outcomes at a minimum of 2 years

Background: Instability of the sternoclavicular joint (SCJ) is a rare problem that is often treated closed, with few published outcomes of surgical treatment with tendon graft reconstruction. Methods: We reviewed a consecutive series of patients who underwent tendon graft reconstruction for SCJ instability over a 7-year period. Cases with acute fractures or fewer than 2 years of follow-up were excluded. Pre- and postoperative function and pain were assessed using Single assessment numeric evaluation (SANE), simple shoulder test (SST), and visual analog scale (VAS) outcome measures. Results: Thirty cases were included, with 27 (90%) available for follow-up at a minimum of 2 years postoperatively. SANE scores improved from a median of 40 to 90. SST scores improved from a median of 3 positive responses to a median of 12 on a 12-point scale. VAS scores decreased from a median of 7 to 0 points. One patient underwent reoperation for recurrent instability and wound dehiscence. Three (11%) patients did not achieve a minimum 30% of maximum possible improvement in SST scores. Conclusions: Tendon graft reconstruction for SCJ instability is a safe procedure with a low complication rate and statistically and clinically significant improvements in patient-reported outcome measures at 2-year minimum follow-up. Level of evidence: Level IV: Therapeutic.