Acromioclavicular Joint Problems: Treatment options

Non-surgical treatment

ACJ arthritis
Physiotherapy will form a key part of your treatment and rehabilitation. In consultation with Mr. Cole, your team of physiotherapists will devise a programme of exercises for you that are designed to prevent any further stiffness and help you to regain your range of motion.

You may be offered painkillers and anti-inflammatory medication to help control the pain and reduce the swelling. This medication may take the form of an injection directly into the damaged joint.

 

ACJ dislocations
If you have only sprained your acromioclavicular joint or have a minor tear of one of the ligaments it is likely that you will not need to have an operation. Treatment will include painkillers to make you feel more comfortable and anti-inflammatory medicine to reduce any swelling. A course of physiotherapy will be devised for you to help strengthen your shoulder muscles, so that they offer greater stability. Your symptoms are likely to resolve over a number of weeks to months. In only a few cases will the pain persist longer and a surgical procedure to stabilize the joint may be considered

 

ACJ stress fractures
The vast majority of stress fractures in the acromioclavicular joint heal well by themselves with a period of complete rest from overhead activities and heavy lifting. You would typically expect bones to heal in about six weeks. You may be offered painkillers and anti-inflammatory medication as appropriate. Your team of physiotherapists will also devise a programme to help strengthen the muscles around your joint. This will help support the joint and may also provide you with some pain relief.

Surgical treatment

ACJ arthritis
Operations are rarely needed in cases of ACJ arthritis. However, if your arthritis is particularly advanced and painkillers are not managing to make you comfortable, Mr. Cole may feel it is appropriate for you. He will discuss your operation directly with you, and your treatment may involve a procedure such as an ACJ excision. This involves the removal of part of the damaged ACJ joint and is normally completed as keyhole (arthroscopic) surgery. This operation will be successful in eliminating symptoms in 90% of the time and can be done as day case surgery

 

ACJ dislocations
If your collar bone is no longer connected to your shoulder blade, you may need a surgical procedure to repair the damaged ligaments and return your collar bone to its correct position. This is done by re-routing another
ligament (the coracoacromial ligament) to the end of the collar bone to stabilize the joint.

You may also need surgery if you have a sprain or a minor tear that does not heal properly within three to six months. In these cases, for example, your joint may continue to cause you pain or you may have trouble with your range of movements. The operation would usually be completed as keyhole surgery (arthroscopic) or through a small incision, you would not normally need to stay overnight in hospital.

 

ACJ stress fractures
If your condition fails to heal adequately on its own, Mr. Cole may discuss the need for an operation with you. The procedure, called an ACJ excision, is the same as that sometimes needed in cases of severe arthritis. It involves the removal of part of the damaged ACJ joint and is normally completed as keyhole (arthroscopic) surgery.

Exercise
Following your surgery, your team of physiotherapists will work with you to devise an exercise programme. This will be designed with advice from Mr. Cole to help you recover as quickly and efficiently as possible.

Referral

At the Southampton Shoulder Clinic we are happy to accept referrals from your GP or any other Health Care Professionals such as your physiotherapist. Arranging an appointment is simply done by contacting Mr. Cole’s personal assistant , Chris Plomer. She will advise of the availability of clinics and arrange an appointment to suit your needs. She will give you any advice that you may need for your Insurance Company.