Sternoclavicular Joint Reconstruction With Gracilis Tendon Autograft
John M. Apostolakos, Toufic R. Jildeh, Rony-Orijit Dey Hazra, Maria E. Dey Hazra, Peter S. Chang, Annabel R. Geissbuhler, Joan C. Rutledge, Peter J. Millett
Abstract
Clinical instability of the sternoclavicular (SC) joint is a challenging problem. Recurrent subluxation and pain can lead to significant functional limitations. Although many patients respond positively to conservative treatment, chronic dislocations often require operative intervention. The complex anatomy of the diarthrodial SC joint and the existence of concomitant SC joint degenerative changes compounded with close-by neurovascular structures present a surgical challenge. The purpose of this Technical Note is to describe a technique for the open management of symptomatic sternoclavicular joint instability using a figure-of-8 reconstruction with a gracilis autograft. The present authors believe this technique provides a technically safe and reproducible method for reconstructing the SC joint without compromising biomechanical strength.