BACKGROUND: Sternoclavicular joint (SCJ) osteoarthritis is rarely treated surgically, and the available published manuscripts are limited to small patient series. The aims of this systematic review were to identify the surgical treatment options for osteoarthritis of the SCJ, describe the quality of the available literature, analyze the outcome and complications and compare open versus arthroscopic surgery. METHODS: Literature was searched in PubMed, MEDLINE and Embase. Single case reports and studies that did not include surgical management were excluded. Data of interest included study year, sample size, diagnosis, sex, age, demographics, clinical data, type of surgical management, follow-up periods, outcomes and complications related to the surgical treatment. RESULTS: Eight articles on series of patients met the inclusion criteria and included 107 patients. Mean patient age was 48.2 years (range 17-72). 68% of patients were female and 32% male. The most commonly described treatment option was arthroscopic resection of the medial clavicle end (56%). Revision surgery was performed in 3 cases
2 following trauma and 1 for persistent pain. The mean follow-up period was 45.4 months (range 28-80). Scores from patient reported outcome measures (Rockwood-, Constant- and DASH-questionnaires) and VAS pain scores all improved significantly from pre- to postoperatively. Four studies with 32 patients reported the overall subjective patient outcome with 84 % reaching excellent or good. There were no randomized controlled trials and no comparative cohorts. Arthroscopic surgery was only reported by one center, and this may induce risk of bias. It was not possible to compare outcomes following open and arthroscopic surgery. CONCLUSION: Based on this systematic review, surgical treatment of SCJ osteoarthritis is a safe procedure which offers good pain reduction and a high rate of satisfaction. It is not possible from literature to conclude whether open or arthroscopic surgery is preferable.