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AC joint

Complaints AC joint

The shoulder is a complex joint.

The shoulder joint consists of three bones:

  • The upper arm (the head of the shoulder).
  • The scapula
  • The clavicle.

The connection between the clavicle and the scapula is part of the AC joint, the acromio-clavicular joint. The AC joint has a lot to do with the movements of the arm. The AC joint is small but the whole shoulder, arm and hand carry the burden. The AC joint is sensitive to irritation and osteoarthritis (wear). This can cause pain and limit range of motion. In order to reduce this pain it can be advised to remove the end of the collar.

Treatment

A piece of the end of the clavicle AC joint will be removed. There are basically two methods:

  • Arthroscopic procedure (keyhole surgery)
  • Open surgery

Your surgeon will discuss with you which method is the best for you. 

Arthroscopic procedure

  • The operation is performed under general anesthesia  or spinal anesthesia
  • The arthroscopic procedure is performed using a video camera with a flush system inserted through a small incision at the backside of the shoulder
  • The entire shoulder joint is evaluated, AC joint diagnosed
  • Using the camera two additional openings are made for the surgery instruments
  • A piece of the end of the clavicle AC joint will be removed
  • The shoulder is rinsed and the wound is closed
  • A wound dressing is placed and a shoulder sling positioned to create a restriction of movement

Open surgery

  • The operation is performed under general anesthesia  or spinal anesthesia
  • An incision is made over the outside of the AC joint.
  • A piece of the end of the clavicle is removed
  • The wound is closed
  • A wound dressing is placed and a shoulder sling positioned to create a restriction of movement

Preparation

The procedure is as follows:

  • You visit the doctor's assistant and/or anesthesiologist to determine whether theca joint operation is possible. Besides they will explain the various forms of anesthesia and pain management, both during and after surgery. More information about anesthesia, click here.
  • The day of surgery is scheduled. You can return home on the on the same day of surgery.  Make sure that someone will pick up after surgery, you should not drive yourself.
  • Take your own medication with you on the day of surgery, unless you have been instructed not to take certain medications e.g. blood pressure, medicines for diabetes and blood thinners.
  • Take two tablets of Celebrex 2 hours before the scheduled surgery time. This is a ‘loading dose’ of the painkiller.
  • Do not use your arm the weeks after surgery
  • Make sure you have enough paracetamol (500 mg, 40 pieces) at home.
  • You do not use makeup, body lotion or nail polish on the day of surgery. A tongue piercing should be removed before surgery. Do not wear contact lenses during surgery.

 

Day of surgery

On the day of surgery you wear comfortable clothing and shoes. Personal items such as medicines, clothing and toiletries take you, and your crutches. Leave valuables at home as much as possible.

The procedure is as follows:

  • You appear sober in our clinic at least half hour before the scheduled surgery time. Sober means you should not eat after midnight the night before surgery
  • After preparation by the anesthesiologist will place the shoulder surgery in the operating room.
  • The operation takes about 60-90 minutes.
  • After surgery you will be moved to the recovery room to recover from your anesthesia
  • The physical therapist will  show you how to exercise 
  • The nurse gives you information about them pain relief, wound care, dressings, etc.
  • When you are restored sufficiently, the anesthesiologist will agree with your dismissal.         

Recovery

  • After 24 hours the bandage may be removed. If the wound does not leak, use a "shower patch", so you can shower again.
  • Do not drive a car the first weeks after surgery.
  • The stitches are removed after about 14 days. Keep the wound dry.
  • If the wound becomes red, painful or you feel ill and have fever: please contact the clinic 
  • The period during which work can be resumed depends on the type of work you do.

Complications

Surgical procedures carry some risk of complications. Complications may be related to anesthesia, for more information, click here.

Consult your surgeon with the following complications:

  • Bleeding in the shoulder
  • The wound remain sensitive sometimes long after surgery
  • Infection of the shoulder
  • Damage to the knee prosthesis structures around the knee, such as nerves or blood vessels

Sometimes the outcome of a shoulder surgery is not what you had expected. Please consult your surgeon.

Expectations


Surgery often has good results resulting in lasting pain relief and improved function.

Frequent asked questions (FAQ)

How long takes a AC resection?
The average duration of a AC resection is between 60 and 90 minutes.

Prepare yourself by reading all the information given. For any questions please telephone or email contact with Orthopedium.