AC Joint Repair

What is AC Joint Repair?

AC joint repair is a surgical procedure performed to repair damaged or torn ligaments and tendons of the acromioclavicular (AC) joint. Depending on the severity of the injury, the surgery can be done through tiny keyhole incisions arthroscopically, or as open surgery through a relatively larger skin incision. 

Anatomy of the AC Joint

The AC joint is situated at the end of the shoulder where the scapula (shoulder blade) and clavicle (collarbone) meet, at a position on the upper section of the scapula called the acromion. The joint is enveloped by a group of ligaments called acromioclavicular ligaments and supported by coracoclavicular ligaments that attach the collarbone with the front portion of the shoulder blade (coracoid process). The AC joint enables motion between the scapula and the clavicle as you move your shoulder.

Indications for AC Joint Repair

AC joint repair may be necessary if you have persistent pain or deformity in the joint several months after receiving conservative treatments to heal the AC joint injury.

Preparation for AC Joint Repair

Preparation for AC joint repair will involve the following steps:

• The doctor will ask you if you have allergies to medications, anaesthesia, or latex.
• You should inform your doctor about any medications, vitamins, or supplements you are taking.
• Alcohol and tobacco should be avoided at least 24 hours prior to surgery.

AC Joint Repair Procedure 

General anaesthesia with a nerve block may be administered. To determine whether to use arthroscopy or open surgery, the site of injury will first be inspected. The most suitable repair method will be chosen based on the type of injury. Pins, anchors, straps, or tendon grafts may be used by your surgeon to repair the joint. The common treatment method involves using temporary screws to keep the realigned clavicle in place, and sutures to mend the ligament injuries. The screws will be left in place until the joint heals, after which they will be removed during a follow-up session.

Postoperative Care 

• Your arm is placed in a sling and your shoulder will be immobilized for a few weeks.
• You may notice pain, swelling, and discomfort in the shoulder area. Pain and anti-inflammatory medications will be provided as needed.
• Eating a healthy diet rich in vitamin D is advised to promote healing and a faster recovery.
• An individualized physical therapy protocol will be designed to help strengthen your shoulder muscles and optimize shoulder function.
• You will be able to resume your normal activities in a couple of months.

Risk and Complications

As with any surgery, AC joint repair may be associated with certain risks and complications such as:

• Wound infection
• Bleeding
• Damage to nerves and vessels
• Thromboembolism or blood clots
• Anaesthetic complications
• Persistence of pain
• Hardware failure
• Failure of the grafts
• Need for revision surgery