An AC joint separation is one of the most common shoulder injuries. It is often referred to as a “shoulder separation.” The injury is a particularly common football and hockey injury and occurs as a result of a direct blow to the top of the shoulder. For football it can be from a tackle where the shoulder is driven into the ground, or from hockey it can occur as a result of a crash into the boards.
“AC” refers to the acromioclavicular joint, which is formed by the acromion bone and the clavicle or “collar bone.” The AC joint is stabilized by the coracoclavicular ligaments or “CC ligaments” (conoid and trapezoid ligaments) and by the acromioclavicular ligaments or “AC ligaments.”
The severity of the injury is dictated how many of these ligaments are damaged. Patients often present with a noticeable prominence at the AC joint on the top of the shoulder following an AC joint separation.
Radiographs and a clinical examination are important to determine the type of treatment best suited for the injury. There is an older radiographic classification scheme called the “Rockwood Classification” that classifies AC joint injuries based on 2-dimensional x-rays into 6 different types.
New classification schemes are based on clinical examination and categorize AC joint injuries on whether they are “stable” or “unstable.” Stable AC joint injuries are best treated with physical therapy and avoiding surgery, whereas, unstable injuries may be best suited for surgery.
A report of the AC joint reconstruction surgical technique that Dr. Morris uses and the results after surgery are published in The Journal of Arthroscopic and Related Surgery: Arthroscopy. There are many reported surgical techniques for AC joint reconstruction.
We believe that this surgical technique described by co-authors Dr. Ben Kibler and Dr. David Dome offers distinct advantages because the surgical technique is an “anatomic” reconstruction meaning that it recreates all of the torn structures in their anatomic position at the time of surgery.
Kibler WB, Sciascia AD, Morris BJ, Dome D. Treatment of Symptomatic Acromioclavicular Joint Instability by a Docking Technique: Clinical Indications, Surgical Technique, and Outcomes. The Journal of Arthroscopic and Related Surgery: Arthroscopy.April 2017; 33(4):696–708.e2. http://dx.doi.org/10.1016/j.arthro.2016.08.023
Dr. Brent J. Morris is a board-certified orthopedic surgeon and fellowship-trained shoulder and elbow specialist in Lexington, Kentucky at Baptist Health Lexington – Orthopedics and Sports Medicine.
Dr. Morris and his shoulder team have published on AC joint reconstruction surgery and ways to improve outcomes following AC joint surgery. He is co-author of an upcoming textbook devoted to shoulder surgery.
Dr. Brent J. Morris is a board-certified orthopedic surgeon and fellowship-trained shoulder and elbow specialist in Lexington, Kentucky at Baptist Health Lexington – Orthopedics and Sports Medicine. Dr. Morris is a fellow of the American Academy of Orthopedic Surgeons (FAAOS) and an Active Member of American Shoulder and Elbow Surgeons (ASES).
Dr. Morris and his research team have published extensively on shoulder surgery and ways to improve outcomes and patient satisfaction following surgery. He is co-author of a textbook devoted to total shoulder, reverse total shoulder replacement surgery, and revision shoulder replacement surgery, Shoulder Arthroplasty, 2ndEdition (https://www.elsevier.com/books/shoulder-arthroplasty/edwards/978-0-323-53164-1).
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