What is an acromiclavicular joint separation?

The acromioclavicular joint (AC joint) is where the collarbone (clavicle) meets the highest point of the wingbone (acromion). The ligaments that surround and stabilize the AC joint are torn. Without any ligament support, the shoulder falls under the weight of the arm and the clavicle is pushed up, causing a bump on the shoulder.

How do you repair an AC separation?

The AC joint will be repaired by making an incision across the top of the shoulder. Dr. Gillespie uses tissue and large suture to stabilize the joint. If the injury is old, reconstructing the ligaments that attach to the underside of the collarbone may be done. Cadaver tendon is used to reconstruct the ligaments. It is your choice to use the cadaver tendon.

Length of Stay

You may stay overnight after this surgery, but often you can go home the same day. You will need to have someone to drive you home after you have been discharged.

Anesthesia

Patients usually have two types of anesthesia for this surgery. The first is general anesthesia, which means you are asleep. The second type of anesthesia is a nerve block. Your arm will be numb and will feel very strange. The nerve block will last about 12-14 hours. The anesthesiologist will speak to you on the day of surgery. The ultimate choice of anesthesia technique is up to you and your anesthesiologist.

Incision

You will have an incision across your shoulder usually on the top. After the incision has healed, it is usually very thin and not very noticeable.

Pain

If admitted to the hospital you will be provided with a PCA (Patient Controlled Analgesia) machine. This is a syringe of pain medication attached to a computer with a button. The computer is programmed with a specific amount of pain medication that can be administered when the button is pressed. When you feel pain press the button and you will receive pain medication. You will also have pain medication prescribed for when you are discharged home. DO NOT take ANY nonsteroidal anti-inflammatory pain medications: Advil, Motrin, Ibuprofen, Aleve, Naproxen, or Naprosyn after surgery.

Sling

Your arm will be placed in a sling prior to leaving the operating room. You are to remain in your sling 24 hours a day. This includes sleeping in your sling. For the four weeks that you are in your sling, you are not permitted to drive.

Dressings

You will go home with tape and gauze dressings. After 2 days you may remove the dressings. There will be a steri strips over the incisions. The streri strips are to remain in place until they fall off on their own. You may see some blue suture (stitch) sticking out the ends of the incision. The suture will be removed at your first postoperative visit 10-14 days after your surgery.

Physical Therapy

Before leaving the hospital you will be taught your home exercise program. For the first three months of recovery you will do these very gentle stretches at home.

Restrictions

Recovery from an AC separation surgery is six months. During that time you will have restrictions on the use of your operative arm.

Day of surgery to Week 6: no use of arm, out of work
Months 1.5-3: opposite hand work only
Months 3-4.5: no lifting or carrying greater than 10 lbs, only occasional reaching
Months 4.5-6: no lifting greater than 20 lbs