The A-C Joint & Distal Clavicectomy
The A-C (acromioclavicular) joint is second only to the rotator cuff as a source of shoulder pain. This joint can be injured in three ways. First a fall on the shoulder can produce a sprain: this is the so-called “separated” shoulder. Secondly the joint can be become painful through degenerative arthritis. Thirdly it can become painful as a result of activities that force the arms together against resistance. The most common example of this is the bench press weight lifting exercise.
Non-Surgical Treatment of A-C Joint Injury
Whatever the cause, a painful A-C joint does not respond to physical therapy. The first treatment is injection of the joint with a cortisone-like drug. This is usually helpful but in most cases the pain returns within a few months. If this occurs, many patients will elect to have outpatient arthroscopic distal clavicectomy.
Surgery – Distal Clavicectomy
This easily performed, arthroscopic procedure entails shaving down the end of the damaged clavicle and the removal of the inflamed or torn disk that exists within the joint. Two or three ¼ -inch skin punctures are made and the arthroscope is inserted. A motorized burr is used to shave the end of the clavicle so that it will not rub and cause pain. Because the ligaments that stabilize the joint are not disrupted, there should be no ill effects on the shoulder from this procedure. While recurrences after surgery can theoretically occur I have never seen this happen.
Patients can resume light activities of daily living almost immediately and usually can resume upper body exercise lightly within a few weeks. Complete recovery occurs within a few months.
Below is a surgical video that shows this procedure being done: