Acromioclavicular joint (AC) Disruption

Dr.Senthilvelan

Consultant Orthopaedic Surgeon

For Appointments and queries Contact 9566222533/nexusortho@yahoo.com

Normal AC joint (The Joint between the end of collar bone and shoulder blade)

The joint between the outer end of the collar bone (clavicle) and shoulder blade (scapula) is called the acromioclavicular joint.

           

X ray of Normal AC joint

This Joint can be injured by falling on point of shoulder with arm by the side. This can result in damage to ligaments around this joint. This can result in prominence of end of collar bone (clavicle) which can be seen or felt as a bump underneath the skin.

Symptoms of AC joint injuries

Symptoms and signs of an acromioclavicular joint injury are pain over the tip of the shoulder and the arm feels             unsupported. There is loss of shoulder movement and prominence of the outer end of the clavicle.

Clinical Picture showing prominent end of clavicle under the skin

X rays Showing AC joint disruption

Treatment of AC joint injuries

Most of these injuries can be managed conservatively in most patients using arm sling, Rest, pain killers, physiotherapy for regaining range of movements in the shoulder. Some of types of AC joint injuries are more complex and require surgery.

Surgical Options

If you remain persistently symptomatic even after having conservative treatment,  surgery would be recommended. Surgery would be done using a synthetic ligament t called Surgilig ^TM.

                                                                        Picture showing Surgilg in position

This ligament allows for tissue ingrowth where the ligaments were torn in your shoulder and help maintain stability. Another advantage is that no other ligament is sacrificed in this repair(unlike other procedures like Weaver Dunn procedure in which coraco acromial ligament is sacrificed)

Post op

Postoperatively the arm is immobilised in a sling for 6 weeks. During this time the patients are allowed to perform pendulum and active assisted exercises. After this time, the patients can use his arm for most everyday living activities. Heavy lifting and resisting exercises are prohibited for a further 6 weeks. After recovery of full range of motion of the shoulder, muscular rehabilitation and sports-specific rehabilitation patients are allowed to return to contact sports. This is usually at three months post-operatively.