What is an acromioclavicular joint injury?
The joint connecting the highest portion of the shoulder (acromion) with the collarbone (clavicle) is the acromioclavicular (AC) joint. The coracoclavicular (CC) ligaments stabilize the clavicle to the coracoid bone. The AC joint, the most commonly injured shoulder joint and occurs when the joint undergoes a separation of the acromion and the clavicle, causing damage to the surrounding soft tissues. An AC joint injury is graded into six different categories based upon the severity of injury to the AC joint capsule and the surrounding CC ligaments. These injuries can vary from a mild separation, classified by the ligaments simply being stretched, to the ligaments being completely severed from their attachment sites. Blunt force traumas directly to the shoulder, such as those experienced in aggressive contact sports or a motor vehicle collision, often result in more severe injuries to the AC joint.
What is the treatment for an AC joint separation?
Non-surgical therapies are often successful in patients with mild AC joint injuries. The joint is immobilized with a sling or other device allowing the ligaments to heal properly. Rest, ice application, and non-steroidal anti-inflammatory medications (NSAIDs) are recommended to control the pain and swelling associated with an AC joint injury. Improving shoulder strength and range of motion is also important for a successful recovery. However, in the event of a complete disruption of the AC joint capsule, surgical repair, to realign the clavicle with the acromion, is often necessary. This realignment is accomplished by suturing the AC joint capsule back into the correct anatomical position. Dr. Ronak Mukesh Patel, orthopedic shoulder doctor, treats patients in Sugar Land, Pearland, and the Houston, Texas area who have suffered an AC joint injury and are in need of surgical reconstruction.
What is an AC joint or CC joint reconstruction?
AC joint or CC ligament reconstruction for an acromioclavicular injury in the shoulder, may need to be performed if the supporting tissues are damaged and cannot be used for the repair. In these cases, AC joint or CC ligament reconstruction is performed, using a tendon graft (called an allograft) passed around the coracoid bone with visualization by the arthroscope to secure the new tissue graft in the correct anatomical position of the original torn shoulder ligaments. The goal of AC joint reconstruction is to replace the original ligaments with a new, strong graft that will bring the arm back to the collarbone in its normal anatomical position.
How is an AC joint repair or reconstruction performed?
An AC joint repair is often performed as an arthroscopic-assisted procedure involving a small camera (arthroscope) and a small open incision. A donated tendon graft (allograft) is also commonly implemented in this procedure. The arthroscope is introduced into the shoulder joint and Dr. Patel methodically examines the shoulder joint for other injuries. Specialized surgical instruments are then utilized to excise and remove any damaged fragments from the ligaments. Reconstruction of the AC joint capsule is accomplished by passing the allograft around the coracoid while visualizing with the arthroscope. The allograft is passed through the clavicle anatomically. The remaining graft may be secured across to the acromion to anatomically restore the AC ligaments. Medical sutures can also be implemented through the tendon grafts to strengthen the repaired tendons during the healing process.
What are the benefits of an arthroscopic AC joint repair or reconstruction?
Dr. Patel prefers the arthroscopic-assisted repair technique when performing an AC joint repair. This minimally invasive surgical approach involves smaller incisions for the arthroscope and surgical tools that often results in a shorter recovery period for the patient. Arthroscopic surgical reconstruction of the AC joint also decreases the risk of blood loss and infection during the procedure and reduces pain and inflammation following the procedure.
What is the recovery period like after AC joint reconstruction or repair?
The recovery period following a successful AC joint repair can vary by the severity and complexity of the AC joint injury. Although the arthroscopic repair technique has been shown to decrease recovery times, the ligaments, tendons, and surrounding soft tissues still take the same amount of time to heal. Most patients can expect a return to their normal daily activities in approximately 3 to 6 months. Patients in Sugar Land, Pearland, and the Houston, Texas area can anticipate the shoulder joint to be immobilized with a sling immediately following surgery to ensure proper healing of the AC joint. The key to a successful recovery following an AC joint repair is the active participation and completion of the physical rehabilitation program designed by Dr. Patel. This physical therapy program will focus on improving shoulder strength and re-establishing a full range of motion.
AC Joint Surgeon
Are you an athlete that participates in high-contact sports? If so, you may be at an increased risk of experiencing an acromioclavicular (AC) joint injury. Mild AC joint injuries can be treated non-surgically with medication and therapies. More severe cases often require surgery to repair the AC joint. Shoulder surgeon Doctor Ronak Mukesh Patel provides diagnosis and personalized treatment plans for patients in Houston, Sugar Land, and Pearland, TX with an AC joint injury. To restore your range of motion, contact Dr. Patel’s team today!