What is ACJ (Acromio-Clavicular Joint) Dislocation?
The ACJ (Acromio-Clavicular Joint) is between your collar bone (clavicle) and the acromion (which is the top part of the shoulder blade on the outer edge of the shoulder).
The joint stability relies mainly on two coracoclavicular ligaments (conoid and trapezoid) that connect the collar bone with the coracoid process (an anterior process of the shoulder blade). If the joint is injured, it may become displaced and unstable, and sometimes surgery is required to repair it.
What causes ACJ Dislocation?
The ACJ connects your shoulder to your clavicle, and can dislocate due to acute injury/trauma i.e. after a fall from a bicycle, a fall from height, during weightlifting, or from a sudden shoulder pull.
How is ACJ Dislocation diagnosed?
An ACJ dislocation can be initially considered following a clinical examination with a specialist. Following that, X-rays and CT scan of the shoulder if appropriate can verify the diagnosis.
You will notice and feel a deformity at the top of the injured shoulder. The shoulder will be painful when moving the arm and at rest.
Treatment and recovery
Not all ACJ Dislocations need surgery.
Depending on the type of the initial dislocation, surgery may be recommended immediately for those with severe Acromio-Clavicular Joint Dislocations. Sometimes, however, rest and then physiotherapy are recommended. If the joint then does not stabilise itself with other alternative treatments such as painkillers, injections, exercise and physiotherapy, surgery is then the treatment of choice.
ACJ Stabtilisation Surgery
The procedure involves repairing the torn ligaments, or replacing them with either natural or artificial ligaments. It is done through an incision (cut) made on the top and the front of the shoulder. If the injury is more than four weeks old, stabilising the ACJ might require both methods (artificial and natural) in order to prevent recurrent instability and pain.
You may go home on the day of surgery, although an overnight stay on the ward may be required. You will then be reviewed by your surgeon and follow a rehabilitation program supervised by specialist physiotherapists.
Your arm will be resting in a sling for four to six weeks. You will not be able to fully use your arm for all activities of daily living during this period but the therapists will advise and guide you on what you can and cannot do.
Depending on the nature of your employment, you may be signed off from working for six to 12 weeks.