AC Joint arthritis and shoulder arthroscopy

AC Joint arthritis and shoulder arthroscopy

The acromioclavicular (AC) joint is part of the shoulder. Formed from the acromion (the bony part of the shoulder blade) and clavicle (collarbone), it serves to attach the shoulder blade to the rest of your body.

Arthritis in this joint is especially common in older patients and weightlifters. It can develop with age, with previous low-grade joint separations also contributing to its appearance. Although it progresses over time and cannot be fully cured, timely management can effectively manage symptoms.

Treatments for AC joint arthritis

Treatment generally begins with conservative approaches, including nonsteroidal anti-inflammatory medication (NSAIDs) and activity modification.

The application of cold packs may assist in reducing inflammation, and corticosteroids may be employed for diagnostic purposes or to reduce pain.

Where conservative approaches are unsuccessful, surgery may be pursued as a course of treatment. Unlike glenohumeral arthritis, AC joint arthritis cannot be treated with joint replacement surgery and requires other approaches.

Arthroscopic surgical treatment for AC joint arthritis

Arthroscopic distal clavicle resection may be used to treat AC joint arthritis which does not respond to conservative managements.

Distal clavicle resection involves shaving away part of the diseased clavicle. This results in more space between the acromion and the clavicle, reducing friction and pain. 5-10mm of the bone is removed and this portion is not replaced.

Indications for surgery

Patients with AC joint instability are not suitable for distal clavicle resection. Removing a portion of the clavicle may increase instability and cause ongoing complications. Further treatment to stabilise the joint may be required.

In some cases, an open distal clavicle resection may be preferred to the arthroscopic approach. This gives the surgeon a better view and wider range of access than the arthroscopic approach.

Suitability and ideal surgical approaches are discussed with Dr Jonathan Cabot at your consultation appointment. As with any surgery, the preferred intervention is determined on a case-by-case basis.

Recovery from AC joint arthroscopy

Immediately after the procedure, your arm will be placed in a sling for comfort. You may reduce use of the sling as pain permits. Post-operative exercises are assumed 1-6 weeks after the procedure and patients most can fully resume activities without pain after 3-4 months.

As arthroscopic distal clavicle resection is a minimally invasive procedure, you generally will not have to remain in the hospital overnight and may return home after the procedure.

Driving within 48 hours of receiving a general anaesthetic is not recommended. After this period, you may resume driving when you can comfortably grip the wheel without pain medication.