Arthroscopic AC Joint Repair Overview
The acromioclavicular (AC) joint is the area where the clavicle (collarbone) attaches to the acromion (roof of the shoulder). The AC joint is stabilized by strong ligaments, coracoclavicular (CC) ligaments, which attach the clavicle to the front of the scapula (shoulder blade). The AC joint and the surrounding structures can become injured from a direct blow to the area during sports activities, a fall or automobile accident. The trauma can cause the collarbone and roof of the shoulder to no longer sit next to each other, referred to as an AC separation. While mild AC separations can be treated with rest, physical therapy and a sling, more severe cases may require an arthroscopic AC joint repair. Dr. Brian Waterman, orthopedic shoulder surgeon, specializes in AC joint repair and AC revision surgery.
AC joint injuries are measured based on grades. A grade 1 or 2 AC injury will cause pain and is commonly caused by a sprain or stretch. A grade 3, 4, 5 or 6 AC injury typically means a ligament tear is present and an arthroscopic AC joint repair will be needed to alleviate chronic shoulder pain and weakness.
Dr. Waterman typically performs an AC joint repair arthroscopically on an out-patient basis. The goal of the shoulder surgery is to secure the collarbone back to its normal position by attaching strong sutures to the front of the shoulder blade and to the collarbone. This technique is often accompanied by reconstruction of the CC ligaments, which involves looping a donated graft from the front of the shoulder blade to the top of the collarbone.
AC revision surgery is also performed as an arthroscopic technique by Dr. Waterman and is reserved for patients who have experienced a failed AC joint repair. The exact AC revision surgery varies for each patient since each case has a unique original injury and failed treatment.
Recovery and Rehabilitation after Arthroscopic AC Joint Repair
All patients will be expected to wear a sling for numerous weeks to protect the arm and keep it immobile following surgery. Physical therapy focused on shoulder range of motion will begin shortly after AC joint repair or AC revision surgery. As the ligaments heal, a physical therapist will progressively strengthen the joint and discard the sling. Patients can expect a full recovery and return to sports activities in three to four months in many cases.