The effect of hormone replacement therapy on postmenopausal sternoclavicular joint arthritis

Abstract

AimTo investigate the effect of hormone replacement therapy on the treat-ment of postmenopausal sternoclavicular joint (SCJ) arthritis.MethodThis cross-sectional study included postmenopausal female patients who presented with complaints of pain and swelling in the SCJ at the Or-thopaedics Polyclinic of Karabuk University Training and Research Hospital between September 2014 and September 2016. After the imaging and labo-ratory tests required for evaluation by an orthopaedic specialist, the patients were referred to the Gynaecology Department for evaluation in respect of postmenopausal symptoms and hormone replacement therapy (HRT). For those with indications, HRT was started. The treatment protocol for SCJ ar-thritis was applied to all patients by the orthopaedics specialist. The patients were separated into two groups: those receiving HRT (Group 1) and those not receiving HRT (Group 2). The sociodemographic and clinical characteristics and laboratory test results were recorded for all patients. All the patients were evaluated by the orthopaedic specialist at the 1st, 3rd, 6th, and 12th month of treatment using the Rockwood Scale (RS) and the Visual Analog Scale (VAS) for pain.ResultsA total of 92 patients met the study criteria and were included for evaluation. As 13 patients did not attend follow-up exami-nations, they were excluded and the study was completed with 79 patients. Group 1 comprised 38 patients who started HRT on the recommendation of the Gynaecology Department and Group 2 comprised 41 patients who were not taking HRT. The mean age of patients was 52.6±5.2 years in Group 1 and 54.1±4.8 years in Group 2. No statistically significant difference was deter-mined between the groups in respect of age, imaging, and laboratory test results (p>0.05). The need for non-steroid anti-inflammatory drugs and intra-articular injection was statistically significantly lower in Group 1 compared to Group 2 (p=0.012, p=0.006 respectively). No difference was determined between the groups in respect of the VAS scores evaluated preoperatively and at 1 month of treatment (p=0.712, p=0.579, respectively). In Group 1, the VAS scores at 3 months (p=0.038), 6 months (p=0.0213), and 9 months (p<0.001) were determined to be statistically significantly lower than those of Group 2. The RS values of both groups were similar preoperatively and at 1 month (p=0.897, p=0.789, respectively), while the results of Group 1 were statistically significantly higher at 3 months (p=0.034), 6 months (p=0.0212), and 9 months (p=0.0392). At the end of 1 year, the results of both VAS and RS were similar in the two groups (p=0.676, p=0.867, respectively).ConclusionThe results of this study showed that with the application of HRT when there were indications, postmenopausal SCJ arthritis was less symptomatic, improved in a shorter time, and required fewer tests and less medication.

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