Acromio Clavicular Joint Injury

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The small bony lump you feel on the top of your shoulder is called the acromio clavicular joint (ACJ), formed where the collar bone (clavicle) meets the top part of the shoulder blade (acromion). Several ligaments hold the joint in place – if these are sprained, there will be pain and inflammation. If one or more of the ligaments are badly torn, the joint can become dislocated. Neglected injuries can lead to acromio clavicular arthritis.

The joint can be injured by falling onto your shoulder, elbow or an outstretched arm.

Pain at the end of the collar bone where it sticks up into the shoulder. Pain when you move your shoulder, especially when raising your arms above the shoulders. Pulling the affected arm across the opposite shoulder provokes discomfort. If you have had neglected the injury for a while, you may notice a weakness in the upper arm and an aching pain on performing overhead activities.

The way the trauma occurred will give a good indication of an ACJ injury, along with the increased prominence of the collar bone. Different types of x-rays will be taken to determine whether the ACJ is dislocated or if the ligaments have just been sprained.

Arthroscopic ACJ stabilisation surgery involves incisions being made over the front and the top of the acromio clavicular joint (ACJ). Damaged ligaments will be repaired and lax or sprained ligaments can be tightened up, so that the shoulder becomes more stable.

If one of the ligaments has been completely torn (dislocation), the collarbone needs to be re-attached to the shoulder blade. To do this, a section at the end of the collarbone is cut off, then one of the other ligaments in the joint is transferred onto the cut end of the collarbone. This graft is held in place with a staple.

ACJ stabilisation surgery might also involve smoothing out damaged surfaces of the bone using abrasion techniques. The collarbone may have become deformed or diseased as a result of the injury, if this is the case, a small section of the end of the bone is removed.

For the first four to six weeks, eating, dressing, cooking etc must be carried out using your un-operated arm, and you will be wearing a shoulder sling. You will not be able to drive for four to six weeks after the operation. You should be able to return to sports eight to 12 weeks after surgery.