Shoulder Problems
Acromioclavicular Joint Dislocation
AC joint dislocation is an injury to the joint at the top of the shoulder where the clavicle (collarbone) meets the acromion (part of the shoulder blade). This injury is commonly caused by a fall directly onto the shoulder, leading to a separation of the joint. I most often seen it with sports-related injuries or accidents (especially bicycles).
DO
Use a sling to support the arm during the initial healing phase.
Apply ice to reduce swelling and pain.
Follow physiotherapy exercises to regain shoulder strength and range of motion.
DON’T
Avoid excessive use of the injured shoulder until you see a Specialist.
Don’t skip physiotherapy sessions, as they are crucial for recovery.
Surgery and beyond…
Surgery for AC joint dislocation is generally performed under general or regional anaesthesia with a nerve block which numbs the whole arm. Patients are usually discharged the same day or after an overnight stay. Painkillers are prescribed for when the nerve block wears off. The patient visits their GP 10 days after surgery for a wound inspection and regular physiotherapy visits are booked. The arm is in a sling for 4 weeks and gentle exercises are allowed to start. I see patients in clinic 6 weeks after surgery and discharge them from clinic after 3 months.
Patients can typically resume regular activities and sports within 3-6 months, depending on the severity of the injury and the success of rehabilitation.
Frequently Asked Questions
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AC joint dislocation is an injury to the joint at the top of the shoulder where the clavicle (collarbone) meets the acromion (part of the shoulder blade). This injury is commonly caused by a fall directly onto the shoulder, leading to a separation of the joint. I most often seen it with sports-related injuries or accidents (especially bicycles).
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The main symptoms of AC joint dislocation include a noticeable bump or deformity at the top of the shoulder. Patients feel pain at the top of the shoulder, which may worsen with movement. There is usually swelling and bruising around the joint shortly after the injury. With an unstable AC dislocation patients can have persistent shoulder weakness with a limited range of motion and difficulty lifting the arm.
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A clinical evaluation by me typically includes taking a detailed history of the injury and a physical examination of the shoulder. X-rays are usually all that is required to determine the severity of the dislocation and how stable or unstable it is.
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In many cases, mild AC joint dislocations can heal with conservative treatment, including rest and physiotherapy. However, severe dislocations may require surgical intervention to restore proper alignment and function. I usually see patients approximately 3 weeks after their injury to perform a clinical examination that in most cases can determine whether surgery is advisable.
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Non-surgical treatment:
Rest and immobilization using a sling.
Pain relief with over-the-counter medications such as non-steroidal anti-inflammatory drugs (NSAIDs).
Gradual physiotherapy to restore shoulder strength and movement.Surgical treatment:
For severe dislocations or those that do not respond to conservative management, surgery may be required. This typically involves reconstructing the torn ligaments and stabilizing the joint. I normally use an implant called a ‘Lockdown’. You can view an animation of the procedure above.