Acromio-clavicular Joint Reconstruction

The acromioclavicular joint (AC joint) is the point where the collarbone and the shoulder blade meet.

In most cases, a sudden, sharp injury such as a fall or blow to the shoulder causes the AC joint to separate. It is sometimes, but not always, accompanied by fractures to the bones themselves.

AC joint separations are classified into six types, which in very general terms indicate the degree of severity. Type 3 and above injuries may need surgical treatment.

Procedure

There are a range of surgical approaches to acromioclavicular joint reconstruction. The common approaches involve reconnecting the joint using a loop suture or sutures supported by buttons. Some techniques also use an artificial ligament or a tendon graft.

Dr Sunil Reddy routinely uses multiple strands of strong 2mm tape and bone-buttons to repair acute injuries and uses a hamstring tendon graft from the thigh for chronic injuries.

Postoperative recovery and rehabilitation

Dr Reddy and the physiotherapist will see you day one following surgery and demonstrate exercises to be performed as well as advise on things to do and not do.

It’s important you follow the advice and rehabilitation guidelines to give yourself the best chance of recovery and an optimal outcome.

• You would likely have a regional / nerve block for pain management apart from a general anaesthetic.
• You would usually stay in the hospital overnight.
• Please take regular pain medication as advised.
• Apply ice packs five times a day for 10 minutes each time for the first two weeks.
• You will need to wear a sling full time for four weeks, but you can remove it thrice daily for 15-20 minutes each time to perform exercises. Avoid active forward elevation for four weeks as this may affect the deltoid repair.
• Please remove the sling for a shower, resting your arm by the side. The dressings are waterproof.
• After four weeks, you can cease using the sling. Progress with exercises as advised by your therapist.
• Strengthening exercises usually start 10 to 12 weeks following surgery.
• Avoid lifting weights and push-pull movements for three months following surgery.
• Driving is permitted only once you come out of the sling and have achieved good control of the arm and a pain-free status. This is usually by the four-week postoperative period.
• Return to work or sport is individualised according to severity of injury and post-operative recovery. Contact sport is discouraged for up to six months.
• Please follow your therapist’s advice regarding exercises and follow the rehabilitation guidelines that you can download below.