Question:I injured my shoulder playing soccer. It's an AC shoulder separation. I'm also on my high school tennis team. If I have surgery to repair the problem, will I be able to get back on the court in time for tennis season?
Answer:Most AC joint separations can be treated nonoperatively. Surgery doesn't restore the joint. It puts all the parts back together to help prevent pain and loss of function. Surgical repair is reserved for patients with painful problems that don't get better with conservative care.
For the overhead athlete, reconstruction makes the most sense if the problem occurs toward the end of the season. This gives you a jump start on rehab and recovery before the next season begins. Without surgical repair, you may miss an entire season.
It's not clear yet if surgery done sooner than later has a better outcome. The best type of operation is still being studied. In a recent review article, three types of surgical methods were described. But the authors point out that studies have not been done to compare which one works best.
For now, when surgery is needed, the tear is usually repaired with a piece of ligament taken from between the clavicle and the coracoid process. The coracoid process is a bony projection coming off the shoulder blade. This operation is called a Weaver-Dunn reconstruction.
Other methods of repair involve transferring a piece of tendon from somewhere else in the body. It can be looped around the two bones to hold them together. Or the surgeon can drill a hole through the bone to create a tunnel. The donor tissue is looped through the tunnel and tied down.
Once your shoulder is examined, the surgeon can advise you as to the best course of action. With conservative care, you may be back to play after only six to eight weeks of rehab. This could take longer after surgery.Steven J. Klepps and David W. Shenton. Current Treatment of Acromioclavicular Separations. In Current Opinion in Orthopaedics. July 2007. Vol. 18. No. 4. Pp. 373-379.
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