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Acromioclavicular Joint Stabilisation
Dr Kau Chung Yuan (许医生)
MBBS (S’PORE)
MRCS (Ireland)
MMed (Ortho)
FRCSEd (Ortho)
What is Acromioclavicular Joint Stabilisation?
The acromioclavicular (AC) joint, located at the top of the shoulder, is a critical component in the complex network of muscles, tendons, and ligaments that provide strength and flexibility to the shoulder. AC joint stabilisation refers to a range of medical procedures aimed at restoring stability to this joint.
AC joint stabilisation aims to alleviate pain and discomfort while preventing further deterioration of the joint, which could lead to chronic conditions or more severe shoulder injuries.
When is Acromioclavicular Joint Stabilisation Needed?
Acromioclavicular joint stabilisation is typically indicated in cases of significant instability of the AC joint, primarily due to injury or chronic degeneration. Determining the need for this procedure involves evaluating patient symptoms, conducting physical examinations, and using diagnostic imaging.
- Traumatic Injuries
Common in athletes or individuals engaged in physical activities, these injuries can range from mild sprains to complete dislocations. - Chronic Degeneration
Often seen in older individuals or those with a history of repetitive shoulder stress. - Persistent Pain
Especially during overhead or cross-body movements. - Visible Deformity
Such as a bump on the shoulder. - Feeling of Instability
A sensation of the shoulder ‘giving way’.
Benefits and Risks of Acromioclavicular Joint Stabilisation
Patients need to understand the benefits and potential risks of acromioclavicular joint stabilisation to make an informed decision about undergoing the surgery.
Benefits
- Pain Reduction: One of the primary benefits is the alleviation of pain associated with AC joint instability.
- Improved Stability and Function: The procedure aims to restore normal function and stability to the shoulder, allowing patients to return to daily activities and sports.
- Prevention of Further Degeneration: By stabilising the joint, the surgery helps prevent further deterioration and potential long-term complications.
Risks
- Surgical Complications: As with any surgery, there is a risk of complications such as infection, bleeding, or reaction to anaesthesia.
- Graft Failure or Loosening: There is a possibility that the graft used to stabilise the joint may fail or become loose over time.
- Limited Range of Motion: Some patients may experience a reduced range of motion in the shoulder post-surgery.
- Need for Further Surgery: In some cases, additional surgery may be required if the initial stabilisation is not successful or if complications arise.
Preoperative Considerations for Stabilisation Surgery
Before acromioclavicular joint stabilisation surgery, various preoperative considerations are crucial for ensuring optimal outcomes. These measures are designed to prepare the patient both physically and mentally for the procedure.
- Comprehensive Health Assessment
This includes evaluating the patient’s overall health, medical history, and any medications they are currently taking. - Focused Shoulder Assessment
Special attention is given to the shoulder to understand the extent of injury or degeneration. - Advanced Imaging
MRI or CT scans may be used to provide detailed views of the AC joint and surrounding structures. - Functionality Tests
Assessing the range of motion and strength of the shoulder to determine the extent of impairment. - Pre-Surgery Physical Therapy
This may be recommended to strengthen the shoulder and improve its range of motion before the surgery.
What Can You Expect During an Acromioclavicular Joint Stabilisation
Understanding what to expect during the acromioclavicular joint stabilisation procedure can help patients prepare mentally and physically for the procedure.
- Anaesthesia: The surgery typically requires general anaesthesia, meaning the patient will be asleep during the procedure.
- Incision and Access: The orthopaedic surgeon makes an incision over the shoulder to access the AC joint.
- Repairing the Ligaments: The primary focus of the surgery is repairing or reconstructing the damaged ligaments that support the AC joint.
- Use of Grafts: In some cases, grafts (either from the patient’s body or synthetic) are used to reinforce the ligaments.
- Stabilising the Joint: The orthopaedic surgeon may use screws, pins, or other fixation devices to stabilise the joint.
- Intraoperative Imaging: Orthopaedic surgeons may use imaging techniques during the surgery to ensure the correct placement of grafts and stabilisation devices.
Postoperative Care and Rehabilitation
After undergoing acromioclavicular joint stabilisation, postoperative care and rehabilitation are essential for a successful recovery and return to normal function. The recovery process involves several stages and requires active participation from the patient.
Immediate Postoperative Care
Initially, this may include pain management, wound care, and monitoring for any signs of complications.
Use of a Sling
The arm is typically immobilised in a sling for a period to ensure proper healing of the joint.
Gradual Increase in Activity
As healing progresses, patients are encouraged to gradually increase their shoulder activities under the guidance of their orthopaedic surgeon and physical therapist.
Physical Therapy
Essential for regaining strength and range of motion in the shoulder. The therapist will guide the patient through specific exercises tailored to their recovery needs.
Pain Management
This may involve medications, ice, or other methods as recommended by the orthopaedic surgeon.
Follow-up Appointments
Regular check-ups with the orthopaedic surgeon are important to monitor the progress of healing and adjust the rehabilitation plan as needed.
Long-term Care
Even after recovery, ongoing shoulder exercises and periodic evaluations may be recommended to maintain joint health and function.
Patient Feedback
Dr. Kau Chung Yuan
MBBS (S’pore)
MRCS (Ireland)
MMed (Ortho)
FRCSEd (Ortho)
Dr Kau (许医生) is a Fellowship trained Orthopaedic Surgeon with a subspecialty interest in Hip and Knee surgery and has been in practice for more than 15 years.
He is experienced in trauma and fracture management, sports injuries, and joint replacement surgery.
- Fellow of the Royal College of Surgeons Edinburgh, Orthopaedics (FRCS, Edin) 2014
- Master of Medicine (Orthopaedics), Singapore (MMed) 2013
- Member of the Royal College of Surgeons Ireland (MRCS, Ire) 2009
- Bachelor of Medicine and Surgery (MBBS, Singapore) 2004
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Frequently Asked Questions (FAQs)
How long is the recovery period after AC joint stabilisation?
The recovery time following acromioclavicular (AC) joint stabilisation varies based on individual health factors, the severity of the joint condition, and the type of surgery performed.
The intermediate phase of recovery, which can extend from weeks to months, involves progressively intensive physical therapy. The final phase of recovery, often spanning several months, is when patients generally regain full strength and functionality.
When can I return to sports or physical activities?
The timeline for returning to sports or physical activities after AC joint stabilisation is dependent on the patient’s healing progress and medical guidance. Full return to sports or strenuous activities is often possible several months after the surgery, but this depends on achieving rehabilitation goals and the orthopaedic surgeon’s assessment of the joint’s healing.
Is the surgery painful?
AC joint stabilisation, like any surgical procedure, can be associated with postoperative pain and discomfort, particularly in the immediate recovery period. However, effective pain management strategies are a fundamental part of postoperative care.
The intensity of pain usually decreases significantly within the first few days or weeks following surgery. Patients are encouraged to communicate openly with their orthopaedic surgeon about their pain levels to ensure effective pain management throughout their recovery.
Are there any alternatives to surgery?
For some patients, particularly those with less severe AC joint injuries or specific health conditions, non-surgical treatments might be viable alternatives to surgery. Common non-surgical approaches include physical therapy, which aims to strengthen the muscles around the joint and improve the range of motion, and medications like anti-inflammatory drugs to reduce pain and swelling.
In some cases, corticosteroid injections may be used to provide temporary relief from pain and inflammation. The effectiveness of these non-surgical treatments varies based on the individual’s condition and response to therapy.
Patients need to discuss the potential benefits and limitations of both surgical and non-surgical options with their orthopaedic surgeon to determine the most appropriate course of action for their specific situation.