The acromioclavicular joint is normally injured from a direct blow to the point of the shoulder most frequently from a fall from a bicycle or in contact sports. This causes the clavicle in almost all circumstances to rise up and be more prominent. Most ACJ injuries can be treated non-operatively initially with few residual symptoms after 6-12 weeks. Early surgical stabilization is likely to benefit those with more severe instability such that the muscle has stripped off the distal clavicle and those in whom the shoulder collapses under the clavicle in resisted internal rotation. Manual labourers and overhead athletes are more likely to be troubled by their ACJ instability and may elect surgical stabilization. There are a number of different techniques for early stabilization that involve either fixing the clavicle to the acromion or coracoid, and then allowing the ligaments to scar up in their reduced position. Dr Rae can talk to you specifically about the option he feels will work best for you.
The most common indication for ACJ stabilization is in symptomatic chronic instability in whom non-operative treatment has failed. In these cases a similar operation has to be performed but in addition the ligament needs to be reconstructed through either a local ligament transfer (Weaver-Dunne procedure), using a hamstring tendon graft taken from the knee, or synthetic ligament. Dr Rae can talk to you specifically about the option he feels will work best for you.
Dr Hamish Rae is a shoulder specialist from Sydney and can offer you more information about your shoulder pain and options for treatment. To make an appointment please call 80055111.