Arthroscopic AC Joint Repair and Reconstruction
What is an AC joint?
The acromioclavicular joint (also known as the AC joint) is one of four joints that make up the shoulder complex. The AC joint is the area where the collarbone (clavicle) attaches to the roof of the shoulder (acromion) which is located away from the neck, on the shoulder. The AC joint is stabilized by four strong ligaments: superior, inferior, (above and below) the coracoclavicular ligaments, and the coracoacromial ligament. The coracoclavicular (called CC ligaments) attach the clavicle to the front of the shoulder blade. If the shoulder sustains an impactful force, either directly or indirectly, the AC joint and it’s supporting ligaments can be disrupted or separated. Dr. James Mazzara, orthopedic shoulder surgeon serving Manchester, South Windsor, Rocky Hill, Glastonbury and surrounding Hartford communities specializes in AC joint repair and reconstruction.
What causes an AC joint separation?
AC joint separations are a common cause of shoulder pain, particularly in young athletes. While AC joint injuries can result from many different causes, most injuries occur during activities with high-impact risk such as contact sports: football, ice hockey or wrestling, for example. AC joint separation typically occurs when a traumatic force causes the collarbone and the roof of the shoulder to no longer sit next to each other. The initial traumatic force drives the acromion inferiorly, while the clavicle remains in its anatomic position and initiates a cascade of injury, beginning with acromioclavicular (AC) ligament failure, followed by failure of the coracoclavicular (CC) ligaments. Severe injuries may disrupt the muscular attachments of the deltoid and trapezius from the clavicle as well. While mild AC separations can be treated with rest, physical therapy and a sling, more severe cases may require an arthroscopic AC joint repair and reconstruction.
Are you a candidate for AC joint repair?
There are two ways to initiate a consultation with Dr. Mazzara:
You can provide current X-rays and/or MRIs for a clinical case review with Dr. Mazzara.
You can schedule an office consultation with Dr. Mazzara.
What is Arthroscopic AC joint repair and reconstruction?
In cases of severe AC joint injury, surgery is needed because chronic AC joint instability causes recurring joint subluxations and activity induced pain and long-term shoulder problems.. The goal of AC joint repair is to secure the collarbone back into its normal position by attaching strong sutures to the collarbone and the front of the shoulder blade. Dr. Mazzara performs this surgery arthroscopically using a small camera to see inside the shoulder. Small instruments are inserted through tiny incisions in the top of the shoulder. If there is significant damage, Dr. Mazzara will often reconstruct the coracoclavicular (CC) ligaments, which involves looping a donated graft from the front of the shoulder blade to the top of the collarbone. In more acute AC joint separations (less than 3 weeks old), the AC joint can be repaired with special Kevlar sutures and anchors alone avoiding the need for a tendon graft.
Arthroscopic AC joint repair and reconstruction is performed on an outpatient basis and patients are asked to wear a sling for several weeks. Within days following the procedure, full range of motion is quickly re-established with the help of physical therapy and special exercises. After the ligaments have healed, patients will be allowed to use strengthening exercises and discard the arm sling. Patients are usually allowed to return to sporting activities around 3 to 4 months after surgery.
If you have experienced an AC joint injury or would like further information regarding treatment options, please contact the office of Dr. James Mazzara, orthopedic shoulder surgeon in Manchester, South Windsor, Rocky Hill, Glastonbury and surrounding Hartford communities.