Arthroscopic acromioclavicular joint excision
Overview of theSurgery
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.
Steps of Surgery
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.
A sling will be given for comfort after the surgery and it has to be worn for a period of 4 weeks. A physiotherapist will examine and teach on the exercises that should be carried for a period of 4 – 6 weeks.This will ensure that a satisfactory function is achieved.
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 minimal.