This is the terminology given to the condition when there is wear and tear of the acromioclavicular joint of the shoulder. As the name describes Acromio clavicular joint is the joint between Acromion (a part of shoulder blade bone) and Clavicle (collar bone). This joint can be easily felt in most of the individuals as it is in the outer edge of the collarbone. To some extent it contributes to the prominence in the front of the shoulder joint.
Arthritis occurring at acromioclavicular joint can be painful and can restrict number of activities and hence reduces the quality of life .As a person becomes older, normal wear and tear, or degeneration, of the cartilage takes place in the joint. There is a loss of cartilage and, over time, the joint can wear out, become larger, and develop spurs (spiny projections from the bone) around the joint.
It is partly related to the stress on the joint over the course of life. The condition is more common in individuals doing lot of overhead activities. Often it can coexist with other shoulder problems such as subacromial bursitis. If there has been an injury to this joint in the past the occurrence of arthritis at a later stage is common. Persons who perform constant overhead lifting, such as is engaged in by weightlifters or construction workers who work overhead, have higher incidence of the disease. Other susceptible individuals are athletes participating in contact sports or engaging in any activity, which may result in a fall on the end of the shoulder. Any blunt force to the shoulder in the course of work, household activities, or accident may cause, over time, arthritis of the acromioclavicular joint.
Similar to arthritis in other joints of the body, there is pain and swelling in the joint as it is used. Overhead activities can be painful. Pain will limit the sports activity and can impair the quality of life.
A thorough physical examination and investigation such as an X ray will be needed to confirm the diagnosis
Initial treatment involves taking adequate painkillers, resting, then when the pain improves to some extent doing physiotherapy exercises to prevent further stiffness and also to regain the lost movement. Injection with a steroid into the joint may be helpful for a short period of time. Occasionally, the injection can give complete relief of pain and there may not be a necessity of further treatment, but often this is not the case and the pain relief usually stays for a short period only. If these measures fail to improve the pain or if the pain recurs then surgery is the treatment. The surgery is done arthroscopically and the procedure is called Arthroscopic excision of Acromioclavicular joint.
We also ensure that the whole team is included in process and that no one is left out during the turnaround. The most crucial part is ensuring some degree of financial stability.
In those who suffer from continuous pain due to Acromioclavicular joint arthritis an Arthroscopic surgery to excise the joint would give a long-term relief.
Arthroscopic surgery is done through two or three tiny incisions of 0.5cm in size around the shoulder joint. Miniature tubular camera is introduced through the small skin incision to visualise the shoulder joint and the space beneath the acromion (subacromial space).
Usually the Acromioclavicular joint is well seen from the subacromial space. A tubular soft tissue shaver and a thin tubular radiofrequency probe are introduced through the skin incision. These instruments clear the adhesions around the joint and this assists in delineating the acromioclavicular joint. Once the joint is well defined a 6mm tubular burr is introduced through the skin incision and 1 depth of the burr (approximately 0.6mm) is excised in either side of the acromioclavicular joint. The wounds will be closed with one stitch for each incision.
As this procedure involves shaving the bone, there may be a degree of pain in the shoulder joint after the surgery. But giving a nerve block will control the pain. The nerve block in the shoulder numbs the whole arm and this would facilitate to feel only minimal pain. The block usually lasts for a period of 24 hours. As the intensity of pain is less after 24 hours, thereafter the pain can be controlled with the help of painkiller medicines taken by mouth.
To get back to full function approximate duration could be around 6 weeks to 3 months after the surgery. The success rate is very high.
The complications include infection, stiffness and frozen shoulder, but the chance is minima
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