Everything you need to know
The AC joint and the SC joint work together at the highest point of the shoulder to keep the shoulder stable and secure. The acromioclavicular joint is the joint at the top of the shoulder., whereas the sternoclavicular joint is the link between the breastbone and the collarbone.
When either one of these joints are injured, it can disrupt the full motion of the shoulder and cause:
- Pain
- Bruising, swelling, or tenderness over the affected joint
- A grinding sound when moving the arm
- A deformity can form where the clavicle or scapula has moved
AC joint SC joint dislocation can cause many issues for patients. It might be that you’ve damaged ligaments and caused disruption to the full function through:
- Accidents and sports:
An SC and AC joint dislocation can happen quite frequently to those who are most active. Most patients find that they can suffer from a joint injury when they’re riding a bike, participating in contact sports, or often working in manual labour.
- Falls:
It’s not uncommon to have a complete separation of the joints occur from falling off a high ledge. Injury often occurs to bones, ligaments, and the shoulder when falling, so to avoid doing damage to your shoulder, always be mindful of your surroundings.
Before
Before an open repair of the SC and AC joint injury can begin, it’s important that you visit an orthopaedic surgeon at St John and St Elizabeth Hospital. Your surgeon will first assess whether this type of operative treatment is right for you through a physical examination.
This may include running tests, X-rays, cross-sectional imaging, blood tests, and more, to ensure the surgical procedure is right for you.
When considering surgery, it’s important to remember that while many patients receive successful results from this operation, every surgical procedure can carry potential risks. However, rest assured that the surgeon will discuss all available treatment options, to make sure that all non-operative alternatives have been exhausted.
If, together with your consultant, you’ve decided that surgery is the right route for you, then your next step will be to schedule in the procedure to relieve your symptoms.
Before your surgery, you will need to come into hospital for a pre-assessment, where we can check your fitness for surgery. This is a standard check and includes a physical exam, blood tests, heart, and lung function tests.
If you take any blood thinners—for example, warfarin or aspirin, tell your doctor straight away, as you may need to stop taking these or modify your intake from a week before surgery. Your doctor will give you specific instructions if this is the case. You should also tell your doctor if you take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen.
During
The surgical repair starts with putting you under an appropriate general anaesthetic. From here, the orthopaedic surgeon will make an incision along the joint injury.
The specific procedure performed during an AC or SC joint repair surgery depends on the nature and severity of the injury. Common methods include:
- Suture Repair: If there is a partial tear or stretching of ligaments, the surgeon may use sutures to repair and tighten the ligaments, stabilising the joint.
- Ligament Repair: If the ligaments supporting the SC joint are damaged or torn, the surgeon may repair them using sutures or other suitable materials to restore joint stability.
- Reconstruction: In cases of severe AC joint separation, where the ligaments are torn or damaged beyond repair, the surgeon may use grafts or synthetic materials to reconstruct the ligaments and restore joint stability.
- Clavicle Reshaping: If there is damage to the clavicle (collarbone), the surgeon may reshape it to its proper alignment and secure it in place with plates, screws, or pins.
Once either surgery is complete, the team will stitch up your incision and then take you to the recovery ward.
Post-surgery
The recovery process typically lasts around from six to twelve months. There are things that patients can do to help speed up the process, these include:
- Wearing a sling:
An arm sling should be used for the first four to six weeks. This will help keep the wound dry and keep your arm stationary.
- Physiotherapy:
Having an upper limb physiotherapist to help you practice motion exercises, gain strength back in your shoulder joint, and to ensure that the joints are no longer completely torn can help encourage recovery quicker.
- Posture:
When recovery from a SC or AC separation, little things like posture can help your body and shoulder blade to position in a way to avoid injury. Before you start an activity, be mindful of moving your shoulder blade down and in towards the spine – as opposed to a back braced position.
Medically reviewed by Mr Abbas Rashid - BSc(Hons) MBBS FRCS(Tr&Orth) on 02/02/2024
How to pay for your treatment
If you’re… paying for yourself
Did you know you don’t need private medical insurance to come to St John & St Elizabeth Hospital? As a self-pay patient, you can access safe, outstanding quality health care at times to suit you.
For scans and tests, as well as to see most consultants, you’ll still need to be referred by a medical professional like your GP, but as a self-pay patient, the process is more straightforward. You won’t need authorisation from an insurance provider, and you’ll have greater choice of consultant and appointment times.
If you’re… insured
St John & St Elizabeth Hospital is approved by all major medical insurance companies. If you have a personal private health insurance policy, or your company provide it for you, you can use it to pay for your care from your initial consultation through to treatment, surgery and aftercare such as physiotherapy. Not all private health insurance plans cover the same things. It’s very important to check exactly what you are covered for with your insurance provider.