Acromioclavicular Joint Excision
The acromioclavicular joint (ACJ) provides an articulation between the clavicle (collar bone) and the shoulder blade. In some individuals this joint can become problematic and can be a source of pain. In some instances removing this joint can improve the function at the shoulder joint as well as decreasing the pain.
The recovery process: what to expect and milestones
Following this procedure it will be necessary to wear a sling for 1-2 weeks; this is primarily due to the fact that with little muscle bulk covering the area and therefore a slightly limited blood supply, the wound can be slow to heal. This is therefore the priority during the first 10 days after the operation.
The sling needs to be worn throughout the day and during the night also. The sling can be removed for washing and dressing. You will need to avoid actively lifting the arm for the above reasons. Also, in the evening the sling can come off and the arm can be rested on pillows when sitting down, such as to watch television.
Any shoulder operation carries with it certain risks, one of which is shoulder stiffness and in some instances this can lead to a frozen shoulder (capsulitis), therefore during the period of immobilisation, physiotherapy and home exercises are recommended to prevent this complication.Pain Control
Pain should be controlled with prescription drugs. On leaving the ward you will have a 5-day prescription, after this time you may be able to downgrade to over the counter analgesics which can be discussed with the pharmacist or you may need to visit your GP to continue with the prescription drugs. Ice can be used at home as a useful adjunct or alternative.Milestones
- Driving - You may begin driving 1 week after your operation or when you feel comfortable
- Returning to work - This will be dependent on your occupation, if you are in a sedentary job you may feel happy to resume work after 1 week. However, if your job involves heavy lifting or using your arm at shoulder height, you may require longer
- Leisure activities - You should avoid sustained, repetitive overhead activities for 3 months
- Swimming: You may begin breaststroke as soon as it is comfortable for you (ususally approximately 6 weeks). However you should wait 3 months before commencing front crawl
- Golf: 12 - 16 weeks post-surgery.
Approximately 3 months after your surgery your symptoms should be 80 % better and will continue to improve up to 9 months post operatively.
Find out more about the rehabilitation process
The Early Goals of Rehabilitation
- Prevent shoulder stiffness during the initial stages of healing.
- Maintain shoulder movement without strong muscle contraction pulling on the wound area.
Weeks 1 - 2: Sling for 1-2 weeks post-surgery
- Pendular exercises out of sling
- Active assisted exercises Flexion, abduction as comfort allows
- External rotation as comfortable
- Neck stretches as required
- Scapula setting in sling.
Weeks 2 – 4: Cease with sling.
- Continue with active assisted exercises as previous
- Increase external rotation
- Introduce hand behind back assisted with walking stick
- Continue scapula setting and postural awareness.
Weeks 4 – 6: Increase Active Range of Movement (AROM) as able.
- Aim for full AROM by 6 weeks
- Commence light resistance exercises at 6 weeks
- Flexion, abduction pulls with theraband
- External rotation with theraband.
Weeks 8 – 12: Focus on increasing cuff power and resistance.
- Introduce combined movements - external rotation with abduction patterns to 45°, 90°
- Proprioception exercises with scapula positioning.