What is an acromioclavicular joint injury?
The acromioclavicular joint, the glenohumeral joint, and the sternoclavicular joint are three joints that form the shoulder complex. The acromioclavicular (AC) joint connects the acromion (the highest portion of the shoulder) with the clavicle (collarbone). This joint is the most frequently injured shoulder joint that occurs when the acromion is pulled away from the clavicle. The separation of these bones can cause the attaching ligaments to simply stretch or become completed severed from their attachment sites, usually as a result of blunt force trauma to the shoulder. Athletes that participate in aggressive contact sports, such as wrestling and football, are more susceptible to experiencing an AC joint injury. Dr. Ronak Mukesh Patel, orthopedic shoulder specialist serving patients in Sugar Land, Pearland, and the Houston, Texas area, has the knowledge and understanding, as well as substantial experience, in treating patients who have experienced an AC joint injury.
Are there different categories of AC joint injuries?
AC joint injuries are classified into six different grades based upon the damage sustained by the AC joint capsule and the surrounding ligaments:
- Grade 1: The AC joint ligaments experience stretching or partial tearing that can cause minimal joint displacement.
- Grade 2: The AC ligament is completely severed from its attachment site causing more substantial joint displacement. The complete ligament detachment predisposes the AC joint to arthritis.
- Grade 3: The AC joint becomes completely separated with this injury causing an obvious shoulder deformity.
- Grades 4-6: These injuries are rare and are often the result of a high-impact force directly on the shoulder, such as a motor vehicle collision. These are the most severe types of AC joint injuries that typically require surgical reconstruction.
What are the symptoms of an AC joint injury?
Because of the various AC joint injury classifications, these injuries can range from a mild sprain to an obvious visual deformity from complete joint separation. Some other common complaints of an AC joint injury include:
- Decreased range of motion of the affected shoulder
- Instability of the AC joint
- Pain at the joint with arm movement
- Bruising and swelling surrounding the affected joint
How is an AC joint injury diagnosed?
A comprehensive medical history including the initial injury will be gathered by Dr. Patel. A thorough physical examination will then be performed to differentiate between the varying degrees of AC joint injury. Diagnostic testing, including x-rays and magnetic resonance imaging (MRI), may be requested to evaluate for damage to the other structures surrounding the AC joint.
What is the treatment for an AC joint injury?
Non-surgical treatment:
Patients with a lower degree of AC joint injury may find that non-surgical therapies alone successfully resolve their symptoms. A sling may be applied by Dr. Patel to immobilize the AC joint to allow for proper healing of the damaged ligaments. A combination of rest, ice, non-steroidal anti-inflammatory medications (NSAIDs), and occasionally an injection can be used to minimize the inflammation and pain associated with this injury. Completing a physical rehabilitation program focused on restoring strength and range of motion to the AC joint is important as the pain can persist for months after the injury.
Surgical treatment:
For patients that experience a more severe AC joint injury, or in the event that non-surgical therapy is unsuccessful, Dr. Patel may recommend surgical repair of the AC joint. Surgical reconstruction is performed with an arthroscopic-assisted AC joint reconstruction. This is a minimally invasive arthroscopic procedure involving a small camera (arthroscope) and specialized surgical instruments. The AC joint can be successfully re-stabilized by simply repairing and tightening the AC joint capsule and torn ligaments; however, in certain cases, suturing a ligament graft may be necessary.
AC Joint Specialist
Have you experienced a blunt force trauma to the shoulder from high-contact sports or a car accident? If so, you may have sustained an acromioclavicular (AC) joint injury. Injury to the ligaments in the AC joint range in severity and result in a decreased range of motion, instability, and pain with movement. AC joint specialist, Doctor Ronak Mukesh Patel, has experience diagnosing and treating patients with an AC joint injury in Houston, Sugar Land, and Pearland, TX. Contact Dr. Patel’s team today!
