AC Joint Fixation

AC joint fixation is a surgical procedure designed to repair and stabilize the acromioclavicular joint after an injury, such as a dislocation or separation. This procedure is typically indicated when non-surgical treatments such as rest, ice, and physical therapy do not adequately address the pain or instability caused by the injury. The primary goal of AC joint fixation is to re-align the joint and restore stability to allow the shoulder to function normally.

AC joint injuries are classified into different grades based on the severity of the separation:

• Grade I: A mild sprain where the ligaments are stretched but not torn.
• Grade II: A partial tear of the ligaments with some separation.
• Grade III: A complete tear of the ligaments with full separation of the clavicle from the acromion.
• Grade IV, V, and VI: More severe dislocations that may require surgical intervention.

Grade III and higher injuries are often treated with AC joint fixation, as conservative treatments may not provide sufficient relief.

AC joint fixation can be performed using either an arthroscopic or open surgical technique. The choice of technique depends on the injury's severity, the surgeon's expertise, and the patient's specific needs.

1. Arthroscopic Technique: This minimally invasive method involves making small incisions around the shoulder. A small camera (arthroscope) is inserted to provide a clear view of the joint, and specialized tools are used to reposition the separated bones. Screws, pins, or plates are then inserted to stabilize the joint.
2. Open Surgery: In more complex cases, an open surgery may be required. This technique involves a larger incision to directly access the AC joint. The bones are repositioned, and hardware is used to secure them in place.

The surgery typically lasts around 45 minutes to an hour, and most procedures are performed as outpatient surgeries, allowing the patient to go home the same day.

After AC joint fixation surgery, patients will need to wear a sling to immobilize the shoulder while the joint heals. The recovery process can vary depending on the extent of the injury and the surgical technique used. In general, most patients will need to rest the shoulder for several weeks and avoid certain movements to ensure proper healing.

Physical therapy is a crucial component of recovery. Once the initial healing phase is complete, rehabilitation exercises will be introduced to restore strength, flexibility, and range of motion. This may include gentle stretching and strengthening exercises for the shoulder muscles. Patients will gradually progress to more challenging exercises as their shoulder regains function.

With proper rehabilitation, most patients experience significant improvements after AC joint fixation surgery. Most people can return to normal activities, including sports and work, within a few months, although some patients may require longer for complete recovery. The outcome largely depends on factors such as the severity of the injury, the type of surgery performed, and the patient's adherence to the rehabilitation program.

AC joint fixation is an effective surgical solution for treating significant shoulder injuries, particularly when the AC joint is severely separated or dislocated. By stabilizing the joint and promoting healing, this procedure can help restore function, reduce pain, and enable patients to return to their normal activities. With a combination of surgery and physical therapy, most individuals can regain full use of their shoulder and return to an active lifestyle without long-term limitations. If you're experiencing persistent shoulder pain or instability, consulting a healthcare professional can help determine if AC joint fixation is the right treatment for your condition.