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AC (Acromioclavicular) Joint Conditions

What are AC (acromioclavicular) joint conditions?

Many problems can occur in the AC joint, where the clavicle (collarbone) meets the highest point of the acromion (shoulder blade bone). The most common include arthritis, fractures, and separations.

AC joint arthritis

Arthritis is characterized by the loss of cartilage in the joint that enables the bones to move smoothly. Like arthritis found in other joints of the body, it results in pain and swelling that worsens with activity. The joint can eventually increase in size with spurs forming around it. Arthritis that is caused by wear and tear in the AC joint is common in weightlifters (a condition known as osteolysis).

How is AC joint arthritis treated?

Once the cartilage no longer exists in the AC joint, it cannot be replaced. However, there are non-surgical and surgical treatment options available to improve the symptoms of AC joint arthritis. They include the following.

Non-surgical treatment for AC joint arthritis

Your doctor may recommend one or more non-surgical treatments, including activity modification to avoid aggravating symptoms, ice therapy, or pain medications to help alleviate symptoms and facilitate healing. If these interventions do not work, your doctor may recommend a cortisone injection to reduce pain and inflammation.

Surgical treatment for AC joint arthritis

If non-surgical interventions do not work, then your doctor may recommend surgery. The procedure is completed by trimming the end of the collarbone to prevent rubbing against the shoulder blade bone. After surgery, recovery typically takes 4 to 6 weeks before range of motion is fully restored, followed by a few more weeks to regain full strength.

AC joint separations

AC joint separations, also known as shoulder separations, most commonly occur from direct falls onto the shoulder, which injures the ligaments that surround and support the AC joint. In severe falls, the ligaments that attach to the bottom of the collarbone tear, creating a separation between the shoulder blade and collarbone. This injury results in a bulge or bump above the shoulder, as the shoulder blade is forced downward from the weight of the arm. AC joint separations can range in severity, from mild to severe. In mild cases, shoulder sprains may not result in a physical bump, while in more severe cases, the sprain may present a very large bump. The more noticeable the bump, the longer it takes to recover and restore pain-free movement.

  • Mild AC joint separation – A sprain to the AC ligament that does not result in collarbone movement and appears normal via X-ray.
  • Serious AC joint separation – A tear to the AC ligament and a sprain or slight tear of the coracoclavicular (CC) ligament, jarring the collarbone out of alignment and creating a smaller bump above the shoulder.
  • Severe AC joint separation – A complete tear of both the AC and CC ligaments, moving the AC joint out of position and resulting in a large bump.

How is an AC joint separation treated?

Both non-surgical and surgical treatment options are available for shoulder separations. Your doctor will perform a complete examination to determine the severity of your injury, informing the best treatment path for you. When the bump is less noticeable, your doctor may evaluate your shoulder separation with use of an X-ray. Holding a weight in the hand while undergoing an X-ray can make the injury more obvious and easier to diagnose.

Non-surgical treatment for an AC joint separation

Your doctor may recommend one or more non-surgical treatments, including the use of a sling, ice therapy, or pain medications to help alleviate symptoms and facilitate healing. Most people experience a return to normal function after experiencing a shoulder separation. Others may experience continued pain, even in cases of a mild bump. Continued discomfort may be caused by:

  • Arthritis
  • Cartilage damage between bone ends of AC joint
  • Abnormal contact between bone ends during movement

Surgical treatment for an AC joint separation

Your doctor may recommend surgery in cases where pain persists, or the shoulder bump is severe. Surgery for shoulder separations includes the following:

  • Reconstructing the ligaments that attach to the bottom of the collarbone. This surgery can be completed arthroscopically or open, with or without a plate.
  • Trimming the end of the collarbone to prevent rubbing against the shoulder blade bone

After successful surgery, your doctor will recommend physical therapy to restore movement and strength.

Get Evaluated at the Hand Center of Louisiana

Timely evaluation and treatment are important for AC joint arthritis and separations. Contact us today to meet with one of our highly trained physicians, who can evaluate your condition and prescribe the best treatment course for you.

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