Osteo-cartilaginous pain syndromes at the chest wall: results of costal cartilage excision

BACKGROUND: Various pathologies of the lower ribs may lead to potentially severe pain in a heterogenous group of patients. Costal cartilage excision (CCE) has been shown to result in durable pain relief in some patients. Even though literature is scarce, we reviewed our experience with surgically treated osteo-cartilaginous pain syndromes (OCPSs) of the chest wall. METHODS: We performed a retrospective case series from two institutions including patients operated for OCPS from 2014 to 2022. RESULTS: Our case series consists of 11 patients (72.7% female) with OCPS that were treated by CCE. The median age was 43.5±17.1 years. Body mass index (BMI) was 23.6±3.4 kg/m(2) (range, 18.5–29.6). The interval between first symptoms and diagnosis was 2.6 years (range, 3–127). In 5 patients, symptoms started after preceding chest wall trauma. All but one case were unilateral with no significant predominance regarding the side (6 left/4 right/1 bilateral). Postoperative length of hospital stay was 2.3±0.6 days. There was no patient morbidity or mortality. At follow-up, OCPS related pain had ceased in 7 of 9 patients (78%). Two patients stated to have significantly less pain and two patients didn’t have a follow-up. CONCLUSIONS: Our analysis indicates that CCE in OCPS is safe and has good long-term results.