ACROMIO CLAVICULAR JOINT (ACJ) ARTHRITIS

Arthritis is an inflammatory condition of joints. There are several types of arthritis and the most common type is osteoarthritis or wear-and-tear arthritis. Arthritis affects various joints in the body and the arthritis in the shoulder can affect the joint at between the collar bone and the shoulder blade. The symptoms include swelling, pain, stiffness, all of which interfere with use of the shoulder.

Who develops arthritis?

Arthritis is often seen in people aged over 40 years however may affect people of all ages. The most common cause is wear-and-tear, as you age you are more prone to develop arthritis. Also, traumatic injuries, fractures and joint dislocation make you more susceptible to develop arthritis. Certain types of arthritis are more common in women than men as in the thumb arthritis.

What are the types of arthritis?

There are over several types of arthritis. The most common are:

Osteoarthritis: Osteoarthritis is also called degenerative joint disease; this is the most common type of arthritis, which occurs often in older people. This disease affects cartilage, the tissue that cushions and protects the ends of bones in a joint. With osteoarthritis, the cartilage starts to wear away over time. In extreme cases, the cartilage can completely wear away, leaving nothing to protect the bones in a joint, causing bone-on-bone contact. Bones may also bulge, or stick out at the end of a joint, and this is called a bone spur.

Osteoarthritis causes joint pain and can limit a person’s normal range of motion (the ability to freely move and bend a joint). When severe, the joint may lose a lot of movement, causing a person to become disabled.

Post-traumatic arthritis: Arthritis developing following an injury to the ACJ is called as post-traumatic arthritis. The condition may develop years after the trauma such as a fracture, dislocation, severe sprain, or ligament tear.

How is arthritis diagnosed?

Diagnosis of ACJ arthritis is made by examining the shoulder, in particular if there is localized pain over this joint, pain on brining the shoulder across to touch the opposite shoulder, pain at the outer end of the collar bone on pressing the collar bone down and pain that disappears with the injection of a local anaesthetic into this joint. X-rays of the joint may be taken to know the severity of the disease and to determine any bone spurs that may cause an impingement of the tendons that rotate the shoulder. USG and MRI can help confirm this diagnosis.

 

 

What are the treatments available for arthritis of the AC Joint?

Nonsurgical treatment methods for relieving pain in an arthritic joint include activity modification, pain medications, physiotherapy, and use of an arm sling, and steroid injections.

 

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Surgery is usually considered if nonsurgical treatment fails to give relief. There are different surgical procedures that can be used and may include:

Excision Arthroplasty: In this procedure, the affected joint surfaces are removed through either an open or keyhole procedure (Arthroscopic AC joint excision). Dr Bala will discuss the options with you and help you decide which type of surgery is the most appropriate for you.

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Rehabilitation

Following surgery, a rehabilitation program, often involving a physiotherapist may help to regain shoulder strength and movement. You may need to use a post-operative sling for a while after surgery that helps to protect the shoulder while it heals. You may need to restrict activities for 2 weeks to let the joint heal properly. You should be able to resume your normal activities within a few weeks of surgery.