Shoulder Surgery: Acromioclavicular Joint Excision

Indications for operation

ACJ arthritis

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Anaesthetic

General Anaesthetic with an interscalene block (Fully asleep with a local anaesthetic injection into the side of the neck will numb the nerves to the shoulder for post-operative pain relief)

Operation type

Arthroscopic

Incisions

Figure 1
Subacromial incisions

3 ½ cm incisions will be made in the shoulder, one to the back, one at the side and one at the front of the shoulder.

Procedure

The gleno-humeral (shoulder) joint will be inspected first followed by the subacromial bursa and the rotator cuff. A soft tissue shaving device will be used to clear any scar tissue away. A bone-shaving device will be used to shape the underside of the acromion (the bone at the top of the shoulder) and remove any excess bone. (This is the subacromial decompression). The same shaver will then be used to remove the acromioclavicular joint and the outer and of the clavicle.

Images

Figure 1
Shoulder anatomy - front view
Figure 2 Figure 3
End view of clavicle - pre op                                    End view of clavicle - post op

Wound Closure

Small butterfly paper stitches will be used to close the wounds.

Dressings

Elastoplast dressings will be placed over the top of the paper stitches and an adhesive bandage over the top of this.

Immediate aftercare

A sling will be placed on the arm and it may feel numb for the rest of the day. You can go home when you feel comfortable and will be given instructions on what to do next.

Further instructions for ACJ Excision rehabilitation