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STERNOCLAVICULAR JOINT OSTEOARTHRITIS: IS SHORTER CLAVICULAR LENGTH A RISK FACTOR?

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Osteoarthritis (OA) is the most common disorder of the Sternoclavicular Joint (SCJ). In our case-control study, we evaluated the relationship between clavicular length and OA at the SCJ.CT scans of adults presenting to the Emergency Department of our hospital were examined to look for OA, defined as the presence of osteophytes, subchondral cysts, or cortical sclerosis at the SCJ. Medial-most and lateral-most points of the clavicle were marked on the slices passing through the SC and AC joints respectively. Using x, y, and z-axis coordinates from the DICOM metadata, clavicular length was calculated as the distance between these two points with 3D geometry.Preliminary data of 334 SCJs from 167 patients (64% males, 36% females) with a mean age of 48.5 ± 20.5 years were analysed. Multivariate regression models revealed that age and clavicular length were independent risk factors for OA while gender did not reach statistical significance. A 1mm increase in length was associated with 9% and 7% reduction in the odds of developing OA on the left and the right respectively. Comparing the mean clavicular length using t-test showed a significantly shorter clavicle in the group with OA (145.8 vs 152.7, p=0.0001, left and 144.2 vs 150.3, p=0.0007, right).Our data suggest that the risk of developing OA at the SCJ is higher for shorter clavicles. This could be of clinical relevance in cases of clavicular fracture where clavicular shortening might lead to a higher risk of developing OA. Biomechanical studies are needed to find out the mechanism of this effect.
British Editorial Society of Bone & Joint Surgery
Title: STERNOCLAVICULAR JOINT OSTEOARTHRITIS: IS SHORTER CLAVICULAR LENGTH A RISK FACTOR?
Description:
Osteoarthritis (OA) is the most common disorder of the Sternoclavicular Joint (SCJ).
In our case-control study, we evaluated the relationship between clavicular length and OA at the SCJ.
CT scans of adults presenting to the Emergency Department of our hospital were examined to look for OA, defined as the presence of osteophytes, subchondral cysts, or cortical sclerosis at the SCJ.
Medial-most and lateral-most points of the clavicle were marked on the slices passing through the SC and AC joints respectively.
Using x, y, and z-axis coordinates from the DICOM metadata, clavicular length was calculated as the distance between these two points with 3D geometry.
Preliminary data of 334 SCJs from 167 patients (64% males, 36% females) with a mean age of 48.
5 ± 20.
5 years were analysed.
Multivariate regression models revealed that age and clavicular length were independent risk factors for OA while gender did not reach statistical significance.
A 1mm increase in length was associated with 9% and 7% reduction in the odds of developing OA on the left and the right respectively.
Comparing the mean clavicular length using t-test showed a significantly shorter clavicle in the group with OA (145.
8 vs 152.
7, p=0.
0001, left and 144.
2 vs 150.
3, p=0.
0007, right).
Our data suggest that the risk of developing OA at the SCJ is higher for shorter clavicles.
This could be of clinical relevance in cases of clavicular fracture where clavicular shortening might lead to a higher risk of developing OA.
Biomechanical studies are needed to find out the mechanism of this effect.

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