The acromio-clavicular joint is a small joint located at the end of the collar bone. Arthritis can occur in the joint, leading to pain in the area. Bone projections called osteophytes can grow next to the joint as part of the arthritis and these can cause irritation of the rotator cuff tendons. These problems can be treated by key-hole surgery to remove approximately 1cm from the end of the collar bone. This normally improves symptoms from the arthritis without leading to any deterioration in shoulder function. Following the procedure a sling is worn for 48 hours for comfort. Then a supervised programme of range of movement and strengthening exercises are commenced under the supervision of our physiotherapists. Recovery occurs progressively with patients returning to work after a period of 6 weeks.

 

Dislocations of the acromio-clavicular joints are common. They usually occur after heavy falls onto the point of the shoulder during activities like rugby, ski-ing and mountain biking. Treatment is determined by the extent of the dislocations. Minor joint displacements can be treated without surgery but more severe displacements require surgery. Currently we recommend using a replacement artificial ligament called a Surgiligament. This is a specially sized polyester ligament which takes over the function of the ruptured ligaments. The ligament is held in place with a screw passed through the collar bone. The ligament has good strength immediately and the use of Surgiligament has allowed us to develop an accelerated rehabilitation programme with the physiotherapist. Patients are normally kept in a sling for the first 2 weeks, lifting activity is limited to below  5kg for 6 weeks but full range of movement is allowed after removal of the sling at 2 weeks. Patients normally return to sporting activity by 3 months.