Acromioclavicular (AC) arthritis occurs when the protective cartilage covering the ends of the bones at the joint between the acromion (bony roof of the shoulder, which is an extension of the shoulder blade) and clavicle (collar bone) wears out. This cartilage can wear out from excessive joint loading, such as in weightlifters or heavy laborers, or following injury. In active patients, shoulder pain and limitations can occur as the worn bony ends of the joint grind together and cause mechanical symptoms and inflammation.
What Is AC Joint Arthritis?
The AC joint is located between the acromion (bony roof of the shoulder) and the clavicle (collar bone). Protective cartilage covers the ends of the bones at this joint. When this cartilage wears out, the worn bony ends of the joint can grind together, causing mechanical symptoms, inflammation, pain, and limitations.
Causes and Risk Factors
- Previous injury to the AC joint that results in premature wearing out of the protective cartilage
- Heavy repetitive loading of the joint, often seen in weightlifters or heavy laborers
- Sports that require contact or collision
- Throwing sports, racquetball, and squash
- Previous shoulder injury, AC joint sprain, or dislocation
Symptoms
Frequent signs and symptoms of AC joint arthritis include:
- Tenderness, swelling, or a bump on top of the shoulder at the AC joint, especially with repetitive overhead activities or heavy lifting
- Loss of strength or increased pain with overhead activities
- Pain with bench pressing or when reaching across the body
Treatment
Initial treatment consists of modifying or stopping aggravating activities, rest, ice, and anti-inflammatory medications to relieve pain. AC joint injections also may be used as part of conservative treatment.
Surgery is not required even if symptoms continue despite non-surgical treatment. Surgery can be performed when the patient decides symptoms are sufficient to undergo surgery.
When symptoms warrant, Dr. Chudik can arthroscopically remove five to seven millimeters of bone from the damaged end of the clavicle. This keeps the worn and painful surfaces from contacting while leaving the surrounding AC joint ligaments to maintain a stable and functional AC joint. This procedure is called a distal clavicle resection (DCR).
At the time of surgery, Dr. Chudik can use the same arthroscopic portals to inspect and treat the shoulder joint, ligaments, labrum, cartilage, and rotator cuff. Sometimes, rotator cuff tears have been found despite a negative MRI and can be repaired at the same time.
Recovery and Outcomes
For patients with symptomatic AC arthritis that does not respond to conservative treatment, surgery to remove the damaged end of the clavicle can often alleviate symptoms and allow a full functional recovery.
Dr. Chudik has performed distal clavicle resection on many heavy overhead laborers and competitive weightlifters who have successfully returned to their full level of activity without limitations.
When to See Dr. Chudik
If pain, tenderness, or swelling at the top of the shoulder persists or worsens, or symptoms continue to interfere with overhead activities, heavy lifting, bench pressing, or other activities, contact Dr. Chudik’s office for an evaluation.
Call 630-324-0402, email contactus@chudikmd.com, or request an appointment online.