AC Joint Injury/Separated Shoulder Treatment
Treatment for an AC joint injury is dependent on the grade of injury. Many grade I injuries are treated with conservative measures. A grade II separated shoulder also typically does well with non-operative management but may require surgical intervention if conservative measures fail. Grade III injury management is based on the activity level and displacement and may require early surgical repair, either arthroscopic, open or both.
Conservative treatment is recommended when the joint is first injured, certainly in grade I cases and most grade II cases. Frequent icing and medication will help control the pain, while immobilization in a shoulder sling helps support the injured joint while it heals. Gentle motion exercises are commonly recommended by Dr. Getelman to prevent stiffness.
A surgical procedure is typically reserved for cases where there is lingering pain or unacceptable joint deformity after several months of conservative treatment, as well as in severe grade III separated shoulder which are classified as a type V when the bone is through the muscle and can damage the overlying skin.
Surgery may be done for pain or for instability of the joint. The simplest type of surgery for a painful acromioclavicular joint injury involves resection or removal of the end of the clavicle using an arthroscopic technique, called the Mumford procedure.
The joint may become painful due to AC joint arthritis or the separation minor, the Mumford procedure can provide satisfactory results in many patients. When the AC joint is dislocated with a severe separation, a more complex reconstructive procedure is needed to restore the clavicle’s position, with an anatomic reconstruction of the coracoclavicular ligaments. Usually this procedure is performed as an arthroscopic assisted procedure by Dr. Getelman who does the preparation arthroscopically and adds a graft through a very small incision over the joint. The graft is then passed beneath the coracoid process and tunneled through the clavicle replacing the torn ligaments and restoring the ac joint anatomically.
For more resources on a separated shoulder, or for additional information on surgical treatment for an AC joint injury, please contact the Van Nuys, Thousand Oaks and Los Angeles, California office of Dr. Mark Getelman – orthopedic shoulder specialist.