AC Joint Arthritis
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AC Joint Arthritis

AC Joint Arthritis

Degeneration of the shoulder joint is referred to as shoulder arthritis, shoulder osteoarthritis, or AC joint arthritis. In a healthy shoulder, the cartilage helps provide a soft cushioning for the shoulder joint. Over time, this cartilage may begin to diminish and degenerate due to aging, causing pain and discomfort. The AC joints enable you to smoothly lift your arms over your head and across your chest. In patients with AC joint arthritis, shoulder movement may be limited or painful.

What is the AC joint?

The shoulder blade, upper arm bone, and collarbone are the 3 bones that make up your shoulder. The upper portion of the scapula is referred to as the acromion. The AC joint is where the acromion and the collarbone meet. These bones are held together firmly by ligaments, which are bodily tissues that hold bone to bone. The acromioclavicular ligaments border the acromioclavicular joints. The AC joints and ligaments form the joint capsule, which is a watertight pouch that encases the joint fluid around the AC joints.

What causes shoulder arthritis?

The joints in your body typically have a healthy amount of cartilage, which is a pliable connective tissue. This joint cartilage helps to enable fluid motion in the shoulder and allows for comfortable shoulder movement. In patients with AC joint arthritis, cartilage tissue becomes irritated and inflamed. This inflammation can cause limited mobility and painful shoulder movements. There are several causes of shoulder arthritis. With each shoulder movement, your AC joints and cartilage experience a small amount of wear and tear. With aging, this everyday wear and tear can cause severe degeneration, resulting in shoulder arthritis. Additionally, patients with jobs or hobbies that require repetitive shoulder movements may be more prone to developing AC joint arthritis. Overuse of the shoulder and acromioclavicular joints can result in an earlier onset of shoulder arthritis. Shoulder osteoarthritis may also stem from a shoulder trauma or injury that damaged the shoulder cartilage.

As the cartilage in your shoulder begins to become inflamed, the space between your shoulder blade and collarbone becomes narrower. In more severe cases, the space between your shoulder bones may disappear completely. This can cause the bones to painfully grind against one another. As a result of grinding, bone spurs may develop along the end of the shoulder bones coming in contact with one another, causing further discomfort and grinding.

What are the symptoms of acromioclavicular arthritis?

The onset of acromioclavicular arthritis symptoms is typically slow and occurs gradually over time. A common symptom of AC joint arthritis is tenderness or pain in the shoulder. This pain and sensitivity is typically located at the top and front of the shoulder. Pain in the shoulder may also be more severe with certain movements or activities. Generally, patients with shoulder arthritis have trouble or cannot lift their arm above their head or across their body. These movements typically cause discomfort and pain. Some patients may find that shoulder inactivity can also lead to increased discomfort. This is often due to the joint becoming more irritated and stiff when not used regularly. Swelling or inflammation of the soft tissue can occur at the front or the top of the shoulder. AC joint arthritis symptoms vary depending on each patient and the extent of their shoulder arthritis.

How can Dr. Rozbruch diagnose shoulder osteoarthritis?

Pain, discomfort, or inflammation at the top or front of the shoulder is a common symptom that suggests shoulder osteoarthritis. Dr. Rozbruch may ask if you have difficulty lifting your arm across your body or above your head, which can be another sign of acromioclavicular arthritis. During a physical examination, Dr. Rozbruch will take note of any visual differences in your shoulder, such as tenderness or swelling. In some cases, a shoulder X-ray may also be suggested. With the results of this X-ray, Dr. Rozbruch can determine if there is a decreased space between your shoulder bones that is a result of deterioration of your shoulder cartilage.

What shoulder arthritis treatments are available?

Typically, AC joint arthritis is first treated nonsurgically. Dr. Rozbruch may suggest avoiding activities that worsen your shoulder pain. Oral anti-inflammatories are often suggested at this stage of treatment to reduce tenderness and swelling within the shoulder. Cortisone injections can be applied to the shoulder to dramatically reduce swelling and pain in the arthritic shoulder. Dr. Rozbruch may also suggest physical therapy to help regain proper shoulder movement. Light shoulder exercises and stretches can help reduce pain, inflammation, and tenderness. A physical therapist can help improve the flexibility and range of motion of your shoulder.

What shoulder arthritis surgery is available?

In more severe cases of AC joint arthritis, shoulder surgery may be suggested. Surgery for an arthritic shoulder can be performed in a variety of ways. AC joint arthroscopy is an arthroscopic shoulder surgery that is designed to remove damaged portions of cartilage. An arthroscope is a small tube with a camera on the end. This camera is connected to a monitor, which will display live images of the inside of your shoulder. Bone spurs can be removed during shoulder surgery to reduce the grinding between your shoulder bones. To alleviate the friction between your 2 shoulder bones, a resection of the collarbone can be performed to recreate space between the 2 bones. This dramatically reduces the friction and grinding of the bones and can alleviate pain and inflammation.

What should I expect after an AC joint arthritis surgery?

Because the majority of surgeries for shoulder arthritis are performed through an arthroscope, recovery time is typically shorter than that of traditional surgeries. The recovery period following arthroscopic shoulder surgery will vary depending on what type of surgery you are undergoing, the extent of your symptoms, and your own rate of healing. Following resection of your collarbone, your arm may be placed in a protective sling to reduce movement. Some patients may be able to go home the same day as their AC joint surgery, but if necessary, you may be required to stay overnight in the hospital to ensure healing. After a few days, you may remove the protective sling from your arm as long as you feel comfortable doing so. Light range-of-motion exercises will be advised in the days following your shoulder osteoarthritis surgery to promote proper blood circulation and prevent blood clots. Physical therapy is often recommended following shoulder surgery for arthritis. Physical therapy can help you regain a proper range of motion in your shoulder and reduce pain and inflammation.

How can I learn more about shoulder arthritis?

To learn more about shoulder arthritis, please request an appointment online or call Dr. Rozbruch’s orthopedic office in NYC at 212-744-9857. Prior to an office visit, please fill out Dr. Rozbruch’s patient forms to expedite your first visit.

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