AC Joint Arthritis

AC joint arthritis usually occurs due to aging and is most common in people over 50. Over time, the cartilage in the AC joint can wear away, leading to painful bone-on-bone contact. This is also commonly seen in people who have been very active in sports or weight lifting, particular with the bench press. In addition, injury to the shoulder, such as an AC joint separation, can accelerate the development of AC joint arthritis.

At the onset of AC joint arthritis, one might feel pain at the top of the shoulder, especially when lifting heavy objects or performing overhead activities. As the condition progresses, individuals may experience a constant, dull ache that worsens with certain movements like reaching across the body or sleeping on the affected shoulder. Other symptoms include:

• Pain and tenderness over the AC joint
• Pain that worsens with overhead activities or cross-body movements
• Loss of strength and flexibility in the shoulder
• Pain that interrupts sleep

Arthritis is a degenerative condition and, unfortunately, the damaged cartilage does not regenerate on its own. However, symptoms can be effectively managed with conservative treatments, and many people with AC joint arthritis can maintain a high quality of life without surgery.

The diagnosis of AC joint arthritis typically involves a physical examination and imaging studies. During the physical examination, your shoulder surgeon Dr. Mayo may ask you to perform certain movements to check for pain and assess the range of motion in your shoulder. X-rays or an MRI may be used to confirm the diagnosis and assess the severity of the arthritis.

Non-surgical treatments for AC joint arthritis include rest, physical therapy, non-steroidal anti-inflammatory drugs (NSAIDs), and corticosteroid injections to reduce inflammation and pain. If conservative treatments are ineffective, surgical options such as arthroscopic debridement or resection arthroplasty may be considered.

Surgery is generally recommended for patients who have severe AC joint arthritis pain that significantly impacts their quality of life and does not improve with non-surgical treatments. The surgery is elective, and can be done at any time. Delaying the surgery will not change the outcome or how the procedure needs to be done.

The most common surgical treatment for AC joint arthritis is a distal clavicle excision (Mumford Procedure). This procedure involves removing a small portion of the end of the collarbone, creating a space for the joint to move without bone-on-bone contact. This can usually be done arthroscopically, resulting in less pain and a quicker recovery compared to open surgery. In some instances of severe arthritis, open surgery is the better option to ensure an optimal outcome.

After distal clavicle excision surgery, you may be required to wear a sling for a week or two to protect the shoulder while it starts to heal. Physical therapy will be initiated soon after the surgery to help regain strength and range of motion in your shoulder. Most people can return to their regular activities within 3 to 6 months, depending on their individual healing process and the extent of their condition prior to surgery.