Question:I was a semi-professional weight-lifter for 20 years but had to retire because of chronic AC joint pain. Last year I had surgery to remove part of the bone and take the pressure off the area. I still have just as much pain. What went wrong?
The acromioclavicular or AC joint is located along the front of the shoulder. It's the point where the acromion meets the collarbone (clavicle). The acromion is a piece of bone that comes off of the shoulder blade and curves over the top of the shoulder joint.
Scar tissue, bone spurs, and other age-related changes can cause pain and loss of function at this joint. Cutting out the distal end of the clavicle where it meets the acromion is often a good way to relieve the pressure and reduce the pain.
Failure to get rid of the pain after clavicle resection occurs when the source of the problem is something besides the ACJ or when joint instability develops after surgery. Sometimes too much bone is removed also contributing to ACJ instability.
Instability is reported in about 10 percent of the cases when the surgeon uses the direct approach instead of the standard bursa method. Damage to the joint capsule and supporting ligamentous structures can cause this kind of problem.
Be sure you go back to your surgeon for follow-up. There may be other treatment options available to you. Re-evaluation at this time may help clear up the original cause of your symptoms.William N. Levine, MD, et al. Arthroscopic Distal Clavicle Resection: A Comparison of Bursal and Direct Approaches. In The Journal of Arthroscopic and Related Surgery. May 2006. Vol. 22. No. 5. Pp. 516-520.
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