Mr Andrew Chambler

Consultant Orthopaedic Surgeon & Shoulder Specialist

All shoulder problems. All shoulder replacements including computer navigated, anatomic and reverse Biological tendon repair. Arthroscopic procedures for rotator cuff, AC Joint and instability problems. Frozen shoulder treatment. Sports Injuries to upper arm.

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AC Joint Dislocation

Your acromioclavicular (AC) joint is formed where your collarbone (clavicle) meets your shoulder blade (scapula) at the part known as the acromion process. Dislocation of this joint normally happens as a result of a direct blow from a high point on the top of the shoulder, and this may occur in a number of contact sports for example. A dislocation of this joint can be very painful and limiting.

However, good, effective treatment is available to help get you out of pain and back to better function as soon as possible. It’s easy to arrange a consultation with me at Sulis Hospital Bath, and as there are no waiting lists, I can help get you back to full strength again without delay.

When I first meet with you, there will be two questions I will be looking to answer; what type of AC joint dislocation have you had and what exactly caused it? The answers to these two questions will help me determine the best course of action.

Assessing the severity of your AC joint dislocation

The AC joint has many ligaments directly surrounding it, as well as very strong ligaments further away from the joint that connect the shoulder blade to the collarbone. The type of dislocation you have will depend on which ligaments have been injured and how extensive the damage to them is.

Dislocations are graded between 1-6. One is like a tiny sprain, while six would describe a pretty awful dislocation that is only very rarely seen. The grading is made based on physical assessment and examination as well as diagnostic images, such as MRI scans or X-rays of the shoulder. These imaging methods can help to give a good idea of how much the bones of the joint have separated.

Treatment for a grade 1-2 dislocation

In general terms, the smaller sprains (grade 1-2) can be successfully treated conservatively. This means that if they are rested, they will tend to settle down after 3-4 months. You may well have a minor prominence of your AC joint, but normally it will still function very well, and without pain. Most rugby players will have this kind of injury at some stage.

Treatment for a grade 3-4 dislocation

Often with grades 3-4 dislocations, a good proportion will settle conservatively. Should you have suffered this level of dislocation, we will have a discussion about treatment options and you may well decide to opt for conservative treatment for 3-4 months. This could well be all you need.

Treatment for a grade 4-6 dislocation

Where the dislocation is graded as a 4-6, treatment will almost certainly require surgery to restore function. Within these gradings, the joint may be quite wide apart, it may be completely disrupted, and the bone may even have gone into muscle. It will be very painful, and you will not have much function in your arm as a result. Should you see me fairly quickly after dislocating the joint to this extent, surgical repair can usually be carried out arthroscopically (this is a form of keyhole surgery). After three weeks or so of the injury, you will probably need to have traditional ‘open’ surgery to reconstruct the joint.

Recovery from AC joint stabilisation surgery

Surgery is done under general anaesthetic as a day case, meaning you will be able to go home the same day. Your arm will need to be in a sling for about two to three weeks, then our Sulis Hospital Bath physiotherapy team will work with you to help strengthen and restore function your shoulder.

Most people will be back to normal again after 12-14 weeks of the surgery, although I have recently treated a lot of triathletes and other athletes who have fallen or come off their bike, who have been able to return to swimming and running after around 6-8 weeks. I always emphasize the importance of recovering at your own pace. After all, a proper recovery is always more important than a rushed one.