Understanding AC / CC Joint Reconstruction
If you’ve experienced a significant injury to the top of your shoulder, perhaps from a fall directly onto your shoulder or during a sports impact, you might have damaged the ligaments that hold your collarbone (clavicle) to your shoulder blade. If this injury is severe, your doctor might discuss an AC / CC Joint Reconstruction procedure. This surgery aims to stabilize the joint at the top of your shoulder and restore its proper position.
What’s Going On with Your AC / CC Joints?
At the very top of your shoulder, there are two key joints that connect your collarbone to your shoulder blade:
- AC Joint (Acromioclavicular Joint): This is where the end of your collarbone (clavicle) meets the acromion, which is the highest part of your shoulder blade. This joint is held together by strong AC ligaments.
- CC Ligaments (Coracoclavicular Ligaments): These are two very strong ligaments (the conoid and trapezoid ligaments) that run from the underside of your collarbone down to a hook-like part of your shoulder blade called the coracoid process. These CC ligaments are the primary stabilizers of the AC joint, preventing the collarbone from “riding up” away from the shoulder blade.
An injury to these ligaments is often called an AC joint separation. These injuries are graded (Types 1 – 6) depending on how many ligaments are torn and how much the collarbone is displaced. For more severe injuries (typically Grade III or higher), where the AC and especially the CC ligaments are fully torn and the collarbone is significantly displaced, surgery might be considered.
When these ligaments are torn, the collarbone can lift up noticeably, causing pain, weakness, and a visible bump at the top of the shoulder.
How Does AC / CC Joint Reconstruction Help?
AC / CC Joint Reconstruction surgery aims to stabilize the AC joint by rebuilding or repairing the torn ligaments, particularly the crucial CC ligaments. The goal is to bring the collarbone back down into its correct position and hold it there while new ligament tissue grows.
During the surgery, the surgeon might:
- Access the Joint: An incision (cut) is made over the top of your shoulder.
- Reduce the Joint: The displaced collarbone is carefully brought back down into its proper alignment with the shoulder blade.
- Reconstruct the Ligaments: A new tendon (graft) is used to create strong new CC ligaments. This graft can come from another part of your own body (an autograft) or from a donor (an allograft). The surgeon may drill small tunnels in your collarbone and coracoid process and thread the graft through these tunnels, securing it to effectively recreate the torn ligaments.
- Sometimes, hardware (like strong sutures with buttons or screws) is also used to hold the collarbone down while the new graft heals and incorporates.
Life After AC / CC Joint Reconstruction:
After your AC / CC Joint Reconstruction, physical therapy is extremely important for a successful recovery and to regain the full stability and function of your shoulder. Your physical therapist will guide you through a carefully structured and progressive rehabilitation program, which typically includes:
- Protecting the Repair: Initially, your arm and shoulder will likely be immobilized in a sling or brace to protect the newly reconstructed ligaments and allow them to heal firmly.
- Gradual Movement Restoration: As the ligaments heal, you’ll begin very gentle, controlled exercises to slowly regain the range of motion in your shoulder and arm, being careful not to put too much stress on the healing joint.
- Progressive Strengthening: Your therapist will introduce strengthening exercises for your rotator cuff, scapular (shoulder blade) muscles, and deltoid, which are vital for supporting the shoulder and taking stress off the repaired ligaments.
- Functional Return: As you progress, your therapist will help you gradually return to your daily activities, work tasks, and sports, focusing on proper mechanics to protect the reconstructed joint.
Recovery from AC / CC Joint Reconstruction is a significant process that requires patience and dedication, often taking several months to a year for a full return to demanding activities. Following your physical therapist’s instructions closely is crucial for achieving the best possible outcome and safely returning to your desired activities with a stable and pain-free shoulder.