Acromioclavicular Joint Stabilisation -Chronic

Delayed (Chronic) AC Joint Dislocation

 

Indications for operation

Chronic ACJ Dislocation

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

Open

Incisions

A 5cm incision will be made over the top of the shoulder

An additional 5cm incision will be made over the inside of the knee to take one of the hamstring tendons. This will be used as a graft to replace the ligaments that have torn.

Procedure

The last 1cm of the clavicle will be removed as this is often a cause of pain if not removed. The top of the coracoid will be exposed and a small hole drilled through it and through the coracoid bone underneath. The Tightrope augmentation device will be passed through these holes and secured.

The Coraco-Acromial ligament will be released from the Acromion and reinforced with a Kevlar stitch. An additional hole will be made in the clavicle towards its end and the stitch will be passed through it. This will be secured over the top of the clavicle.

 

Full text of the original technique (pdf)

Images

Figure 1
Shoulder Anatomy - front view
Figure 2

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 Stabilisation rehabilitation