Do you Need Surgery for AC Joint Sprain?
Type 1 and 2 AC joint separations are treated non-surgically. A sling is prescribed for comfort, but patients are encouraged to come out of the sling for gentle range of motion exercises. Patients are encouraged to ice the shoulder. Over the counter pain medications may be needed. Physical therapy is prescribed. The physical therapist may try certain taping techniques which can help decrease pain.
For Type 4,5, and 6 AC joint separations, surgery is recommended as the results of non-surgical management are poor. Surgery typically consists of arthroscopic or open AC joint reconstruction in which the AC joint is re-aligned and held in the proper position with strong suture material and the torn ligaments may be reinforced with a donor tendon. Patients go home the same day as surgery, are placed in a sling for up to 8 weeks, but easy range of motion exercises and physical therapy is started immediately after surgery.
The Treatment of Grade 3 AC joint separations is somewhat controversial amongst shoulder surgeons. Dr Cunningham prefers a more conservative, non-surgical approach when managing these acutely as most patients do well without surgery. However, patients will always have a visible bump over the AC joint if managed without surgery. If after several months, a patient is still having pain, weakness and disability, then AC joint reconstructive surgery can still be performed with good results. For some overhead athletes or for patients that do a lot of overhead work, Dr. Cunningham may recommend immediate surgical treatment for acute, Type 3 AC joint separations.