Separated Shoulder Surgeon

Are you an athlete who participates in contact sports? If so, you may be at risk of sustaining an AC joint injury a CC injury, or a separated shoulder. Injuries to the AC joint are quite common in the athletic population. Separated shoulder surgeon, Doctor Riley J. Williams provides diagnosis as well as surgical and nonsurgical treatment options for patients in Manhattan and New York City, NY who have sustained an AC joint injury or a separated shoulder. Contact Dr. Williams’ team today!

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What is an acromioclavicular joint?

The acromioclavicular (AC) joint is one of three joints located of the shoulder. The AC joint is the most vulnerable to a separation injury because of its anatomic location on the top of the shoulder. The AC joint connects the highest portion of the shoulder (acromion) with the collarbone (clavicle). This joint is stabilized by superior (upper) ligaments, inferior (lower) ligaments, the coracoclavicular (CC) ligaments, and the coracoacromial ligament. The CC ligaments anchor the scapula (shoulder blade) to the clavicle; these ligaments stabilize the clavicle and prevent this bone from migrating upward during normal activities. The CC ligaments are commonly injured with falls or other types of shoulder trauma. Mild AC joint injuries are characterized by low-grade stretch injuries to these ligaments without shoulder deformity. More severe AC joint injuries are noted when there is high grade partial or complete disruption of the stabilizing ligaments. Obvious shoulder deformity is observed in these severe injuries; these conditions are associated with blunt force trauma. An injury to the CC ligaments is considered part of this AC joint injury spectrum and is often seen with other shoulder injuries (i.e., labrum tears). Dr. Riley J. Williams, orthopedic shoulder surgeon, treats patients in Manhattan, New York City, and the surrounding New York boroughs who have suffered an AC joint injury.

What is the treatment for AC joint separation or a CC ligament injury?

AC joint injuries are graded into six different classifications based on the severity of injury to the AC joint capsule and surrounding ligaments. Grades 1-3 are degrees of separation typically caused by a sprain or stretching of the ligaments. Grades 4-6 are the most severe types of AC joint injuries involving a complete disruption of the AC joint and CC ligaments. These severe injuries require surgical reconstruction to realign the clavicle with the highest point of the shoulder. This can be accomplished by one, or both, of these surgical methods:

  • AC joint repair: The AC joint capsule and ligaments are primarily repaired using sutures.
  • CC ligament reconstruction: Utilizes a tissue autograft or allograft to reconstruct the CC ligaments and return the clavicle to its correct the position relative to the shoulder blade.

How is AC joint repair & CC ligament reconstruction performed?

An AC joint repair is done in a minimally invasive manner by using an arthroscope (small camera) and specialized surgical instruments to realign the clavicle with the highest point of the shoulder. Surgical anchors, that are fastened within the bone, aid in securing the torn ligaments back to their correct anatomical position. AC joint reconstruction is performed using the arthroscope and several small incisions; this procedure reconstructs the CC ligaments using a tendon graft,. The graft replicates the normal course of the CC ligaments by wrapping the graft around a hook on the scapular (coracoid process) and attaching the free ends of the graft into the clavicle. This surgery stabilized the AC joint and reduces the deformity.

What are the benefits of an AC joint repair?

Dr. Williams prefers the arthroscopic method for an AC joint repair because it is minimally invasive. Due to the size of the camera and specialized surgical instruments, the incisions are small and allow for a faster recovery time for the patient. Arthroscopic surgical repair also reduces the risk of infection, blood loss, as well as decreased pain and inflammation.

How long is the recovery period after AC joint repair?

Although the recovery period is variable, most patients can expect to return to daily routine and sporting activities 3-4 months following a successful AC joint repair. A sling is strongly encouraged for 2-3 weeks following surgery to allow the AC joint repair to properly heal. Full range of motion of the shoulder is quickly re-established through physical therapy. After the ligaments have completely healed, patients will be allowed to discard the arm sling and reintroduce strengthening exercises.

For more information on AC joint repair, CC ligament reconstruction, or to find a treatment for shoulder separation, please contact the office of Riley J. Williams, MD, an orthopedic shoulder surgeon serving Manhattan, New York City, and the surrounding New York boroughs.