ACROMIOCLAVICULAR JOINT DISEASE
If you click on the link above you can download my patient information booklet. It has detailed information with colour pictures. The following is a summary of the important information.
The acromioclavicular joint is a joint located at the top of your shoulder. It is between the acromion (part of the shoulder blade) and the clavicle (collarbone).
Two groups of people get difficulties in this area. The first group is young people often who do heavy work or lift heavy weights at the gym. It is thought that the joint is damaged from repeated minor injuries and eventually the end of the collarbone gets eroded away.
The second group of patients is older people who have gradual wear and tear in that joint. This is similar to arthritis seen in other parts of the body.
People with problems in this area complain of pain at the top of their shoulder which is worse when lifting their arm above their head or doing heavy work. It is often worse at night and they may have difficulty lying on this side.
A separate group of patients may have an acute injury to the acromioclavicular joint. This is sometimes known as a shoulder separation and often occurs in a sporting injury or a direct blow on the shoulder. Examples include a fall from a bike, in a tackle or with direct impact on the shoulder. In this situation the collarbone pops up and a lump is noted underneath the skin. Symptoms often settle down but occasionally patients have chronic pain which is similar to the degenerative conditions discussed above.
Many people with acromioclavicular joint problems do not need surgery; they may have very minimal or in fact no symptoms. Occasionally, the x-ray may show very marked degenerative changes but even then patients may be completely asymptomatic and any problem in the shoulder comes from other causes.
If the pain is significant then surgery is sometimes required. Most times this can be handled with arthroscopic surgery where a small section of the end of the collarbone is removed. This stops the two bones rubbing together and relieves the pain. Other ligaments hold the bone in place and the shoulder works completely normally including for sport or heavy work. Occasionally an artificial ligament is inserted and a tendon is transferred; this requires an open (not arthroscopic) operation.
If an arthroscopic-only operation is done there is no limitation on your movement following surgery. You may choose to use a sling for a few days to help with the pain. If a more major operation has been performed the recovery period can be somewhat longer although you should be able to come out of the sling within the first few weeks.
As with all shoulder surgery, recovery is very prolonged and it can take at least one year before you are completely comfortable. Lying on the shoulder can be particularly bothersome for a year.
As with any surgery complications can occur and they are dealt with in a separate section.