On Monday I will be having a right shoulder acromioclavicular joint (AC) resection. The AC joint is at the top of the shoulder and is the site where the clavicle (collar bone) meets the highest point of the shoulder blade called the acromion. When athletes have shoulder separations, the ligaments holding the clavicle tear. It’s common for this joint on both shoulders to become damaged in RA patients (AAOS). I have have had symptoms on both shoulders for several years. The right has always been the worse probably because that is my dominant arm. Two steroid injections on the right side provided little relief. I received an injection on the left side this week.
Using x-ray and MRI, the surgeon found that the joint was damaged to the point that no cartilage remained, bone was rubbing on bone, and bone spurs were protruding into other tissues. The MRI image posted below shows the damaged joint. There should be a clean line of demarcation between the two bones with 5-10mm of cartilage in between. The image shows a tangled mess of bone spurs. The rotator cuff lies directly under this joint and he said that there was some fraying of this tendon but it wasn’t too bad. A question remains about the nature of the biceps tendon which also runs into this area. There is a possibility that visual inspection of the area during surgery will result in other soft tissue repairs.
The procedure will be conducted via arthroscope which involves several small incisions to the shoulder from various angles to allow access for cameras and tools. This will avoid larger incisions through tissue. This is the first arthroscopic surgery I’ve had on a joint (my sinus surgery was endoscopic) and hopefully this will result in less pain and faster recovery. If no other soft tissues are repaired, the recovery will involve wearing a sling for a week or so, refraining from any heavy use of the shoulder, and starting physical therapy after six weeks. Updates will be posted in the coming weeks.