Acromio-Clavicular Joint (ACJ) Reconstruction

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Aim:                       

Reduce pain, shoulder dysfunction or neurological symptoms due to an ACJ dislocation

Synthetic graft used to replace ruptured coracoclavicular ligaments

                               

Surgery type:        

Open

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Anaesthetic:          

General (asleep) usually with a nerve block

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Objective:              

Incision form end of clavicle (lump) to coracoid process in front of shoulder

End of clavicle identified and trimmed to reduce chance of later arthritis

Clavicle reduced into joint to check initial position

Muscle over coracoid process split and bone identified

Tunnel created under coracoid and length gauge passed around bone

Gauge passed below and around clavicle

Clavicle reduced and graft length measured

Real graft (PTFE/Teflon) shuttled around coracoid and clavicle

ACJ/Clavicle reduced and single screw and washer used to fix graft in place

Ligaments and joint capsule repaired with stitches

                               

Duration:               

45-60 mins

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Scars:                     

1- oblique on front of shoulder- approx. 5-8cm

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Sling:                     

As comfortable but usually majority of time for 3 weeks.

Remove for exercises and as comfortable

Aim to wean from sling completely by 3 weeks. Teach axilla hygiene and washing out of sling

 

Sports:                   

Non-contact sports and free swimming at 3 months

Contact and racquet sports at 4 months

 

Work:                     

Sedentary work- 4 weeks

Physical job- 8-10 weeks

Repetitive over shoulder height work- up to 12 weeks

 

Driving:                 

Short distances as pain allows from 3 weeks