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Journals / Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi / 2026 / Volume: 13 Issue: 2

Sternoclavicular Joint Osteoarthritis Correlates with Rotator Cuff Tear Severity

Sternoklaviküler Eklem Osteoartriti, Rotator Manşet Yırtığının Şiddeti ile İlişkilidir

Fatih Emre Topsakal(ERZURUM ŞEHİR HASTANESİ)0000-0002-6033-0795
Nasuhi Altay(SAĞLIK BİLİMLERİ ÜNİVERSİTESİ, ERZURUM BÖLGE SAĞLIK UYGULAMA VE ARAŞTIRMA MERKEZİ)0000-0002-5518-3938
Pages
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Publication Date
2026-08-27
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Increasing SCJ osteoarthritis severity is independently associated with greater RC tear severity in patients older than 45 years, supporting dedicated SCJ evaluation during comprehensive shoulder assessment.

📌 3 Key Takeaways

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Objective & Hypothesis:The sternoclavicular joint (SCJ) is the only osseous articulation linking the upper extremity to the axial skeleton and contributes to shoulder biomechanics.
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Key Findings & Data:This study aimed to investigate the association between SCJ osteoarthritis severity and RC tear severity in patients older than 45 years, while accounting for relevant confounders.
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Conclusion & Impact:Increasing SCJ osteoarthritis severity is independently associated with greater RC tear severity in patients older than 45 years, supporting dedicated SCJ evaluation during comprehensive shoulder assessment.
🔬Design:Modeling & Simulation
📍Scope:2020 Verileri
⚙️Variables:Sternoclavicular Joint · Rotator Cuff · Osteoarthritis

Abstract

The sternoclavicular joint (SCJ) is the only osseous articulation linking the upper extremity to the axial skeleton and contributes to shoulder biomechanics. The relationship between SCJ osteoarthritis and rotator cuff (RC) pathology, however, remains incompletely characterized. This study aimed to investigate the association between SCJ osteoarthritis severity and RC tear severity in patients older than 45 years, while accounting for relevant confounders. In this retrospective cohort study, the records of 400 consecutive patients who underwent arthroscopic rotator cuff repair between 2020 and 2024 were screened. Sixty patients with radiographic evidence of the full spectrum of SCJ findings, ranging from normal (Grade 0) to severe osteoarthritis (Grade 3), were included; Grade 0 cases were deliberately retained as an internal reference group to enable dose–response analysis across the entire SCJ severity continuum. SCJ osteoarthritis was graded from 0 to 3 using the Wirth–Rockwood classification on bilateral shoulder radiographs, and RC tear severity was graded from 0 to 5 on magnetic resonance imaging using a modified Patte classification. To control for potential confounders, a multivariable linear regression model including age, sex, body mass index (BMI), diabetes mellitus, and smoking status was constructed in addition to Spearman's correlation, chi-square testing, and univariable linear regression. A strong positive correlation was observed between SCJ osteoarthritis severity and RC tear severity (Spearman's ρ = 0.705; p < 0.001; χ² = 46.99; p < 0.001). After adjustment for age, sex, BMI, diabetes, and smoking status in multivariable linear regression, SCJ osteoarthritis grade remained an independent predictor of RC tear severity (adjusted β = 0.91; 95% CI 0.70–1.12; p < 0.001; adjusted R² = 0.54), confirming that the association was not explained by these confounders. Increasing SCJ osteoarthritis severity is independently associated with greater RC tear severity in patients older than 45 years, supporting dedicated SCJ evaluation during comprehensive shoulder assessment.

Özet

Sternoklaviküler eklem (SKE), üst ekstremiteyi aksiyel iskelete bağlayan tek kemiksel eklem olup omuz biyomekaniğinde önemli bir rol oynar. Bununla birlikte SKE osteoartriti ile rotator manşet (RM) patolojisi arasındaki ilişki henüz net olarak tanımlanmamıştır. Bu çalışmanın amacı, 45 yaş üzeri hastalarda SKE osteoartriti şiddeti ile RM yırtığı şiddeti arasındaki ilişkiyi, ilgili karıştırıcı faktörleri de göz önünde bulundurarak araştırmaktır. Bu retrospektif kohort çalışmada, 2020–2024 yılları arasında artroskopik rotator manşet onarımı uygulanan 400 hastanın kayıtları tarandı. SKE görüntüleme bulgularının tüm spektrumunu (Evre 0 normal eklemden Evre 3 ileri osteoartrite kadar) temsil eden 60 hasta çalışmaya dahil edildi; Evre 0 olgular, tüm SKE şiddet spektrumu boyunca doz–yanıt ilişkisinin değerlendirilebilmesi amacıyla iç referans grubu olarak bilinçli biçimde korundu. SKE osteoartriti Wirth–Rockwood sınıflamasına göre 0–3 arasında, RM yırtığı ise modifiye Patte sınıflamasına göre 0–5 arasında derecelendirildi. Karıştırıcı faktörleri kontrol etmek amacıyla yaş, cinsiyet, vücut kitle indeksi (VKİ), diyabet ve sigara kullanımını içeren çok değişkenli doğrusal regresyon modeli kuruldu; ayrıca Spearman korelasyon analizi, ki-kare testi ve tek değişkenli doğrusal regresyon uygulandı. SKE osteoartriti şiddeti ile RM yırtığı şiddeti arasında güçlü pozitif korelasyon saptandı (Spearman's ρ = 0,705; p < 0,001; χ² = 46,99; p < 0,001). Yaş, cinsiyet, VKİ, diyabet ve sigara kullanımı için düzeltme yapıldıktan sonra SKE osteoartriti evresi RM yırtığı şiddetinin bağımsız bir öngörücüsü olarak anlamlılığını korudu (düzeltilmiş β = 0,91; %95 GA 0,70–1,12; p < 0,001; düzeltilmiş R² = 0,54). Bu bulgu, gözlenen ilişkinin incelenen karıştırıcı değişkenlerle açıklanamayacağını göstermektedir. 45 yaş üzeri hastalarda artan SKE osteoartriti şiddeti, RM yırtığı şiddeti ile bağımsız olarak ilişkilidir ve kapsamlı omuz değerlendirmesinde SKE'nin ayrıca incelenmesini desteklemektedir.

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Cite This Article

Topsakal, F. E., Altay, N. (2026). Sternoclavicular Joint Osteoarthritis Correlates with Rotator Cuff Tear Severity. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi, Volume: 13 Issue: 2. https://doi.org/10.47572/muskutd.1861434

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