ACROMIOCLAVICULAR JOINT PROBLEMS
Acromioclavicular Joint (ACJ)
The AC joint is located at the tip of the shoulder where the acromion portion of the shoulder blade (scapula) and collarbone (clavicle) join together. The AC joint is not as mobile as the large main shoulder joint and only moves when the shoulder is overhead or across the chest (adducted). The joint is partly filled with a thick pad of cartilage, known as the meniscus, which allows the joint to move. The AC joint is stabilised by its capsule and additional ligaments (coraco-clavicular ligaments).
Arthritis is a degenerative disease of a joint. Thus, arthritis of the AC joint is a degenerative disease of the acromioclavicular joint or AC joint.
As a person becomes older and uses the shoulder, normal wear and tear, or degeneration, of the cartilage takes place in the joint. There is a loss of cartilage and, over time, the joint can wear out, become larger, and develop spurs (spiny projections from the bone) around the joint. This degeneration results in a condition known as osteoarthritis. Similar to arthritis in other joints of the body, there is pain and swelling in the joint as it is used. AC joint arthritis—osteoarthritis of the acromioclavicular joint—is common in middle age.
The principal cause of AC joint arthritis is use. As a person uses his/her arm and shoulder, stress is placed on the joint. This stress produces wear and tear on the cartilage, the cartilage becomes worn over time, and eventually arthritis of the joint may occur. Another cause is an old injury to the AC joint, such as AC joint dislocation. Any activity that can put pressure on the joint, either normal or excessive, may eventually cause the arthritis condition.
- Physiotherapy – to prevent any further stiffness and regain range of motion
- Painkillers and anti-inflammatories
- Injections into the painful joint – this usually provides good temporary relief. Recommend ultrasound guided injection to place the medicine accurately into the joint.
- Surgery – required for advanced disease, with pain not controlled with painkillers
Types of Surgery:
ACJ Excision – removal of the AC joint. This may be done as an open procedure or arthroscopically (keyhole). We prefer to perform this arthroscopically.
- Keep doing as much of your normal routine as possible.
- Maintain a healthy weight.
- Remain active to keep muscle strength from diminishing. If you work up to a well-designed exercise program, you can keep or even improve joint flexibility.
- Keep repetitive overhead activity to a minimum.
- Rest only when joints are very painful.