Types I and II do not, in isolation, require early surgical intervention.
However, late post traumatic, osteoarthritis can occur, which may be significantly symptomatic (pain when carrying weights and high elevation) to warrant treatment in the form of injections or surgery.
When surgery is indicated to reconstruct the ACJ, this is best done very early after injury, ideally within the first 3 weeks. Surgical intervention is designed to reduce the clavicle (replace it in the correct position) and stabilize the clavicle by reconstructing the coracoclavicular ligaments (which will have been torn), as well as the coracoacromial ligaments. Some of the surgical reconstruction options include the ” Tightrope” or the “Surgilig” implants.
Further more the joint itself will have been disrupted , often a tear of the meniscus ( internal “floating” cartilage) will occur. Sometimes it is possible to repair and reconstruct this meniscus and the joint; but often the degree of disruption and damage is so great as to preclude successful reconstruction. In this case, an excision hemi arthroplasty can be considered, which entails removing a small section of the lateral end of the clavicle and half the A.C.Joint, leaving a gap of approx 10 mm. These options should be discussed with the surgeon.
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