Injury to the Acrmioclavicular or AC joint occurs commonly from falling onto the point of the shoulder. A sprain of the connecting ligaments results in a mild injury, and gives pain at the top of the shoulder and consequently short term restricted use of the arm. More severe injuries cause a complete disruption of the AC joint, and in certain cases the associated stabilizing coracoclavicular ligaments can also be damaged.
There are a number of grading systems used in the assessment of AC joint injuries. These systems are helpful, but are a guide to treatment only. The best approach is to have your injury assessed by an experienced health professional specialising in upper limb injuries, as different factors often come into play when deciding on the most appropriate course of treatment. This way you will have your treatment tailored to your situation, needs and activity requirements.
In general mild injuries do not require surgery for a good long-term outcome. In the rare cases where persistent pain is a concern this maybe addressed once healing of the joint has taken place.
Severe disruption to the AC joint involving complete rupture of both the AC joint ligaments and the coracoclavicular ligaments generally requires surgery.
Surgery is aimed at optimizing shoulder function by:
• Reducing the risk of ongoing pain
• Restoring the joint dislocation to the normal position to minimise the dropped shoulder appearance
• Minimising clicking and catching of the AC joint
• Maximise the ability to carry out sustained overhead activities
• Maximise sporting ability during sports requiring throwing or large stresses on the shoulder
AC joint separations are generally treated most easily at, or shortly after the time of injury. Chronic dislocations of the AC joint can also be addressed, but may be more involved and require complete reconstruction. Surgery is may be conducted as a day procedure or with an overnight stay.
Physiotherapy generally starts with a consultation where tips on the shoulder sling and on maintaining the flexibility of the shoulder a given to patients prior to discharge. Further follow-up is generally orgnaised at this time also and generally follows the protocol published under the AC joint Post Operative Physio section of this website.