AC Joint Repair and Reconstruction
The acromioclavicular (AC) joint is the meeting point of the acromion and clavicle bones, often indicated with a visible bump in the area. AC joint injuries often occur as a result of a fall or other trauma, which may cause the acromion to move or separate from the clavicle, or cause the ligaments to be stretched or torn.
While conservative treatment is often used first for AC joint injuries, surgery may be required for injuries that are more severe or those that cause prolonged pain. Surgery for AC joint injuries may involve removing the end or restoring the position of the clavicle to relieve pain and allow the patient to resume normal functioning of the joint.
These procedures may be performed through arthroscopy or through a traditional open procedure, depending on the type and severity of each patient’s individual condition. Arthroscopy offers patients smaller incisions, shorter recovery times and less trauma. Your surgeon will decide which type of procedure is best for you after a thorough evaluation of your condition.
A labrum is a protective cuff of cartilage found in ball and socket joints like the hip and shoulder. They provide more stability, cushioning and a full range of motion for these shallow joints. A tear in the labrum, known as a labral tear, is caused by injury or overuse and can lead to pain and “catching” of the joint while moving.
While many labral tears can be treated by managing pain symptoms and undergoing physical therapy, some cases require surgical treatment. Labral repair surgery aims to repair unstable shoulders with staples, anchors or sutures. The procedure is usually performed through arthroscopy, which allows the doctor to view the tear through a small camera and perform the procedure through tiny incisions. Larger tears may require an open procedure.
Labral repair surgery is usually effective in treating labral tears and restoring full movement and strength. Recovery time depends on the type of procedure but usually takes several months.
Rotator Cuff Repair
The rotator cuff is a group of tendons and muscles that support the shoulder joint and allow for complete movement while keeping the ball of the arm bone in the shoulder socket. These tendons and muscles may become torn or otherwise damaged from injury or overuse and can lead to pain, weakness and inflammation. Surgery may be used to treat this often serious condition.
Rotator cuff surgery may be performed laparoscopically or through an open procedure, depending on the type and severity of the condition. Both procedures are performed under general anesthesia and aim to reattach the tendon back to the arm, along with removing any loose fragments from the shoulder area.
Rotator cuff repair surgery is usually successful in relieving shoulder pain, although full strength cannot always be restored. Recovery time depends on the type of surgery, but can take several months. As with any surgery, there are certain risks involved with rotator cuff repair such as infection, pain or stiffness, nerve damage or the need for repeated surgery. These complications are rare and most people receive successful outcomes from this procedure.
Arthroscopy is a minimally invasive surgical technique that involves several small incisions into which a fiber-optic device (arthroscope) and tiny surgical instruments are inserted. Orthopedic surgeons can diagnose and treat many different shoulder conditions with arthroscopy, while patients can benefit from less tissue damage, shorter recovery times, less scarring and less post-operative pain. This technique also avoids cutting any muscles or tendons in order to gain access to the affected area.
Shoulder arthroscopy is often performed to confirm a diagnosis after a physical examination and other imaging procedures have been performed. Some conditions can also be treated during the same procedure by inserting a few additional instruments into the joint area.
Arthroscopy can be used to treat many conditions that affect the shoulder joint. Shoulder arthroscopy, also known as shoulder scope, can be used to treat:
- Rotator cuff tears
- Labral tears
- Impingement syndrome
- Biceps tendonitis
- AC joint arthritis
While arthroscopy offers many benefits over a traditional open procedure, it is not for everybody. Some conditions, especially those that are not easily visible with the arthroscopic camera, may be better suited for traditional surgery. Your doctor will decide which type of procedure is right for you.
A separated shoulder is a common injury that most often affects athletes in contact sports. This injury to the acromioclavicular (AC) joint is usually the result of a fall on an outstretched hand (FOOSH), severe lateral sheering-force, or a fall on the tip of the shoulder. It is important to note that this is not the same as a shoulder dislocation: a dislocation (subluxation) of the shoulder occurs exclusively in the glenohumeral joint.
Types of Shoulder Separation
Shoulder separation injuries are classified according to their severity, with type I being the most benign and type VI being the most severe. Type I injuries consist of general trauma to the AC ligaments with no serious tears or fractures. A type II injury is tougher, as it must involve a completely severed AC ligament in addition to an acutely traumatized coracoclavicular ligament.
Type III injuries are composed of fully severed AC and coracoclavicular ligaments and formation of a permanent bump on the clavicle. The most severe types require the same makeup as a type III injury, but with additional displacement of the clavicle into various soft tissues surrounding the area.
Typically, types IV through VI all require surgery but there is controversy as to whether a type III injury would benefit significantly from surgery. Recently, it has been recommended to consider surgery as a preemptive measure against future arthritis concerns.
Treatment and recovery varies greatly between the classes of shoulder separation, from a few weeks of bed rest with anti-inflammatory drugs to arthroscopic surgery requiring months of physical rehabilitation.
The Weaver-Dunn Procedure is the most frequently used surgical technique for the repair of shoulder separation. This procedure allows stability in the joint to be maintained effectively by attaching the acromial end of the coracoclavicular ligament to the displaced clavicle bone, while replacing the aforementioned ligament with alternative connective apparatus or tissue.
To learn more about our shoulder orthopaedic services, please call 760-434-0033 today to schedule a consultation.