Acromioclavicular Joint Repair
The acromioclavicular (AC) joint injuries are graded in severity from a Grade I injury to a Grade VI injury. Grade I, II and III injuries are usually treated non-operatively. Grade IV, V and VI injuries usually require operative treatment. When the injuries are acute Dr. Lenarz can occasionally treat them arthroscopically depending on the severity of the injury. When the injury is chronic, open coracoclavicular reconstruction of the ligaments that have been torn may be necessary. In this procedure the ligaments that have been torn are reconstructed with a ligament taken from another part of the body or from a cadaver. This is done as an open procedure and is usually done as an outpatient. The procedure can be done at the hospital or an outpatient surgical center.
The most difficult part of the repair for the patient is the period of recovery, the initial immobilization (8 weeks) and eventual progression of range of motion and strengthening. Failure to follow these recommendation and their timeline increases the risk of the bone being pulled away from the glenoid so it is unable to heal. This increases the risk for recurrence and further joint pain.
After the surgery, the patient will wake in the recovery room in a sling. If a “nerve block” was performed by the anesthesia doctor before the operation the arm will remain numb for 12-24 hours. This is usually done for post-operative pain control. Icing the shoulder should be done liberally. This can be through the use of ice in a bag, ice packs or a circulating ice water cooler. The dressing should not be removed and the patient may shower the day following surgery. The patient is asked to NOT scrub the incisional area and dressing but allow water to wash over them.