Complications after sternoclavicular surgery.

Abstract Background Sternoclavicular joint (SCJ) pathologies such as instability are rare, therefore SCJ surgery is performed infrequently. Complications of these surgeries can be devastating. This study evaluated complications, and particularly infections, after SCJ surgery. Methods A retrospective cohort of 68 patients who underwent SCJ surgery with a minimum follow-up of one year was reviewed. Patients’ characteristics, intraoperative and postoperative complications were retrieved. In case of a reoperation relevant data from the reoperation and microbiological findings were collected. Results Twenty-two men and 46 women with a mean age of 37.5 years (range 13–70) were analyzed. A complication occurred in 26 out of 68 patients (38.2%). In 16 patients (23.5%) this was an infection. Cutibacterium acnes was the pathogen in 14 of these infections. Infection happened more often in men than in women (p=.02). A total of 26 reoperations were performed in our cohort: 14 due to clinical signs of infection, nine due to instability, one due to complaints of SCJ osteoarthritis and two due to other causes. Conclusion Complications after SCJ surgery happen more often than previously described. C. acnes infections are often seen. When left untreated these complications can lead to persistent complaints or recurrent instability due to failure of reconstruction. Therefore it is of utmost importance to identify infections at an early stage, or better, to prevent them. The use of benzoyl peroxide gel preoperatively seems effective in reducing early C. acnes infections in this type of surgery. Level of evidence Level IV; Case Series; Treatment Study