Advanced search
1 file | 521.06 KB

Arthroscopy of the sternoclavicular joint: an anatomic evaluation of structures at risk

Author
Organization
Abstract
Recently, arthroscopy of the sternoclavicular joint (SCJ) has been described in clinical setting. The aim of this study is to examine the accessibility and safety of the SCJ by arthroscopy in a cadaveric model. An inferolateral and superomedial portal to the SCJ was created in 20 cadaveric specimens. After debridement, the specimens were dissected with a needle positioned in the portal tracts. The distance between the needles and bony landmarks, tendons and ligaments were measured. The integrity of the posterior capsule was evaluated macroscopically. In eight specimens, after anterior dissection, the needles were replaced by K-wires that perforated the posterior capsule to evaluate the distance to the neurovascular structures behind the SCJ. Both portals were found to be safe while allowing good access to the joint. The superomedial portal went through the tendon of the sternocleidomastoideus muscle and the inferolateral portal through the pectoralis major muscle. The portals entered the capsule medial and lateral to the anterior sternoclavicular ligament. The posterior capsule was never perforated during debridement. The perforating K-wires, however, usually perforated either a major vein or artery, but were at a safe distance from the vagal nerve. In this cadaver study, arthroscopy of the sternoclavicular joint could be used as a minimally invasive procedure allowing debridement of the joint without damaging the posterior capsule of the joint. If the capsule is inadvertently be breached, a major risk of neurovascular damage exists. We advise to have a backup of a cardiothoracic surgeon when performing this procedure.
Keywords
Sternoclavicular joint, Arthroscopy, Aorta, Innominate vein, Nervus vagus, Safety, MANAGEMENT, INFECTION, ARTHRITIS, EXCISION

Downloads

  • (...).pdf
    • full text
    • |
    • UGent only
    • |
    • PDF
    • |
    • 521.06 KB

Citation

Please use this url to cite or link to this publication:

Chicago
Van Tongel, Alexander, Tom Van Hoof, Nicole Pouliart, Philippe Debeer, Katharina D’Herde, and Lieven De Wilde. 2014. “Arthroscopy of the Sternoclavicular Joint: An Anatomic Evaluation of Structures at Risk.” Surgical and Radiologic Anatomy 36 (4): 375–381.
APA
Van Tongel, A., Van Hoof, T., Pouliart, N., Debeer, P., D’Herde, K., & De Wilde, L. (2014). Arthroscopy of the sternoclavicular joint: an anatomic evaluation of structures at risk. SURGICAL AND RADIOLOGIC ANATOMY, 36(4), 375–381.
Vancouver
1.
Van Tongel A, Van Hoof T, Pouliart N, Debeer P, D’Herde K, De Wilde L. Arthroscopy of the sternoclavicular joint: an anatomic evaluation of structures at risk. SURGICAL AND RADIOLOGIC ANATOMY. 2014;36(4):375–81.
MLA
Van Tongel, Alexander, Tom Van Hoof, Nicole Pouliart, et al. “Arthroscopy of the Sternoclavicular Joint: An Anatomic Evaluation of Structures at Risk.” SURGICAL AND RADIOLOGIC ANATOMY 36.4 (2014): 375–381. Print.
@article{4216613,
  abstract     = {Recently, arthroscopy of the sternoclavicular joint (SCJ) has been described in clinical setting. The aim of this study is to examine the accessibility and safety of the SCJ by arthroscopy in a cadaveric model. 
An inferolateral and superomedial portal to the SCJ was created in 20 cadaveric specimens. After debridement, the specimens were dissected with a needle positioned in the portal tracts. The distance between the needles and bony landmarks, tendons and ligaments were measured. The integrity of the posterior capsule was evaluated macroscopically. In eight specimens, after anterior dissection, the needles were replaced by K-wires that perforated the posterior capsule to evaluate the distance to the neurovascular structures behind the SCJ. 
Both portals were found to be safe while allowing good access to the joint. The superomedial portal went through the tendon of the sternocleidomastoideus muscle and the inferolateral portal through the pectoralis major muscle. The portals entered the capsule medial and lateral to the anterior sternoclavicular ligament. The posterior capsule was never perforated during debridement. The perforating K-wires, however, usually perforated either a major vein or artery, but were at a safe distance from the vagal nerve. 
In this cadaver study, arthroscopy of the sternoclavicular joint could be used as a minimally invasive procedure allowing debridement of the joint without damaging the posterior capsule of the joint. If the capsule is inadvertently be breached, a major risk of neurovascular damage exists. We advise to have a backup of a cardiothoracic surgeon when performing this procedure.},
  author       = {Van Tongel, Alexander and Van Hoof, Tom and Pouliart, Nicole and Debeer, Philippe and D'Herde, Katharina and De Wilde, Lieven},
  issn         = {0930-1038},
  journal      = {SURGICAL AND RADIOLOGIC ANATOMY},
  language     = {eng},
  number       = {4},
  pages        = {375--381},
  title        = {Arthroscopy of the sternoclavicular joint: an anatomic evaluation of structures at risk},
  url          = {http://dx.doi.org/10.1007/s00276-013-1195-0},
  volume       = {36},
  year         = {2014},
}

Altmetric
View in Altmetric
Web of Science
Times cited: