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Mr Andrew Chambler

Mr Andrew Chambler

Consultant Orthopaedic Surgeon & Shoulder Specialist

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AC Joint Dislocation

Your acromioclavicular (AC) joint is formed where your collarbone (clavicle) meets your shoulder blade (scapula) at the part known as the acromion process. Dislocation of this joint normally happens as a result of a direct blow from a high point on the top of the shoulder, and this may occur in a number of contact sports for example. A dislocation of this joint can be very painful and limiting.

However, good, effective treatment is available to help get you out of pain and back to better function as soon as possible. It’s easy to arrange a consultation with me at Sulis Hospital Bath, and as there are no waiting lists, I can help get you back to full strength again without delay.

When I first meet with you, there will be two questions I will be looking to answer; what type of AC joint dislocation have you had and what exactly caused it? The answers to these two questions will help me determine the best course of action.

Your acromioclavicular (AC) joint is formed where your collarbone (clavicle) meets your shoulder blade (scapula) at the part known as the acromion process. Dislocation of this joint normally happens as a result of a direct blow from a high point on the top of the shoulder, and this may occur in a number of contact sports for example. A dislocation of this joint can be very painful and limiting.

However, good, effective treatment is available to help get you out of pain and back to better function as soon as possible. It’s easy to arrange a consultation with me at Sulis Hospital Bath, and as there are no waiting lists, I can help get you back to full strength again without delay.

When I first meet with you, there will be two questions I will be looking to answer; what type of AC joint dislocation have you had and what exactly caused it? The answers to these two questions will help me determine the best course of action.

Assessing the severity of your AC joint dislocation

The AC joint has many ligaments directly surrounding it, as well as very strong ligaments further away from the joint that connect the shoulder blade to the collarbone. The type of dislocation you have will depend on which ligaments have been injured and how extensive the damage to them is.

Dislocations are graded between 1-6. One is like a tiny sprain, while six would describe a pretty awful dislocation that is only very rarely seen. The grading is made based on physical assessment and examination as well as diagnostic images, such as MRI scans or X-rays of the shoulder. These imaging methods can help to give a good idea of how much the bones of the joint have separated.

Treatment for a grade 1-2 dislocation

In general terms, the smaller sprains (grade 1-2) can be successfully treated conservatively. This means that if they are rested, they will tend to settle down after 3-4 months. You may well have a minor prominence of your AC joint, but normally it will still function very well, and without pain. Most rugby players will have this kind of injury at some stage.

Treatment for a grade 3-4 dislocation

Often with grades 3-4 dislocations, a good proportion will settle conservatively. Should you have suffered this level of dislocation, we will have a discussion about treatment options and you may well decide to opt for conservative treatment for 3-4 months. This could well be all you need.

Treatment for a grade 4-6 dislocation

Where the dislocation is graded as a 4-6, treatment will almost certainly require surgery to restore function. Within these gradings, the joint may be quite wide apart, it may be completely disrupted, and the bone may even have gone into muscle. It will be very painful, and you will not have much function in your arm as a result. Should you see me fairly quickly after dislocating the joint to this extent, surgical repair can usually be carried out arthroscopically (this is a form of keyhole surgery). After three weeks or so of the injury, you will probably need to have traditional ‘open’ surgery to reconstruct the joint.

Recovery from AC joint stabilisation surgery

Surgery is done under general anaesthetic as a day case, meaning you will be able to go home the same day. Your arm will need to be in a sling for about two to three weeks, then our Sulis Hospital Bath physiotherapy team will work with you to help strengthen and restore function your shoulder.

Most people will be back to normal again after 12-14 weeks of the surgery, although I have recently treated a lot of triathletes and other athletes who have fallen or come off their bike, who have been able to return to swimming and running after around 6-8 weeks. I always emphasize the importance of recovering at your own pace. After all, a proper recovery is always more important than a rushed one.

Patient stories

Dr Vidan Masani

I had injured my right shoulder 12-13 years ago, but as it was only a fairly mild injury (a grade 2) it was treated conservatively. More recently, I was playing football when I injured my left shoulder. This was a more significant injury than I had previously had on the other shoulder, and I was diagnosed with a grade 4 dislocated AC joint.

I’m a respiratory consultant myself but have a number of orthopaedic consultant friends, so I asked one of them (who was a knee specialist) who they would recommend. They told me that Andrew Chambler at Circle was the person I should see.

I saw Andrew at Circle and talked with him about things. I was quite surprised when he told me that I would need surgery to repair the joint. However, he explained that while I would be able to function ‘okay’ without surgery, I would be limited in certain activities and movements; certainly, it would limit my ability to participate in certain sports. Certainly, from the X-ray of my shoulder I could see there was a pronounced dislocation visible.

I opted to have the surgery, which was a day case procedure and went well. Despite Andrew advising me on what I should expect in terms of recovery times, I did underestimate how long it would take me to fully recover and be back to full function again (I’m sure I’m not the only person guilty of this). It turns out that Andrew knows what he’s talking about.

Since having the surgery, I am now back to playing football and have also started playing some rugby. I am able to tackle with confidence using my left shoulder and am not apprehensive at all that my shoulder might not be strong enough. I am really enjoying being able to be fully engaged in a physical sport like rugby without having to try to protect my shoulder.

Andrew had explained before the surgery that the joint would be stronger than the other one afterwards, and this is giving me the confidence to play rugby and football. I am able to enjoy the activity itself instead of constantly worrying about the risk of injuring it again.

Mr Andrew Chambler

Mr Andrew Chambler

Consultant Orthopaedic Surgeon & Shoulder Specialist

View full profile
How to find us
Just 10 minutes from Bath
The Sulis Hospital Bath,
Foxcote Avenue,
Peasedown St John,
Bath, BA2 8SQ
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By Car

Sulis Hospital is located 6 miles south of Bath city centre. Travelling from Bath, head south west on the A367. After you pass the Audi and Mercedes-Benz dealerships, on your left, take the first exit at the roundabout into Wellow Lane. Then turn left into Foxcote Avenue. Sulis Hospital is immediately on your right hand side.

Parking

A visitors' car park is located directly in front of the hospital. This is free of charge to patients and visitors.

By Public Transport

There are regular buses to Peasedown St John. Please note the nearest bus stop is a short walk.