AC Joint Osteoarthritis

If you have pain around the bony lump on top of your shoulder, it is possible that you have arthritis in your acromioclavicular joint.

Ongoing shoulder pain, stiffness or lack of mobility should be diagnosed as soon as possible to prevent or treat the degenerative condition of osteoarthritis.

Osteoarthritis is a bone disease that can often be treated conservatively and very effectively in its early stages. Later stage ACJ arthritis may require surgery to restore pain-free movement to your shoulder.

Comprised of leading consultant surgeons and in-house radiologists, the London-based Capital Orthopaedics team offers fast, thorough and effective treatment for arthritis in the shoulder or any other shoulder conditions.

For more information or to book an appointment with Simon Moyes and the Capital Orthopaedics team, contact us here.

What is AC Joint Osteoarthritis?

Your collarbone (clavicle) and the top part of your shoulder blade (acromion) form a joint called the ACJ (acromioclavicular joint). The muscles, tendons and ligaments around the ACJ enable you to rotate and move your arm upwards.

Osteoarthritis is a degenerative bone disease caused by overuse or a traumatic injury.

If the slippery cartilage that coats your bones is damaged, it can expose the rough bone surface underneath. This causes friction in the joint, and can lead to the bone being worn away. It can also lead to inflammation and swelling in the soft tissues around the joint, and muscle weakness.

Your body may produce extra bone in an effort to heal, leading to bony lumps (bone spurs) forming on the surface. This inhibits the smooth movement of the joint and affects the soft tissues around it.

What are the Symptoms of AC Joint Osteoarthritis?

Typical ACJ arthritis symptoms include:

  • Pain, especially when raising your arm overhead or moving it horizontally across your body
  • Tenderness at the bony point on the top of your shoulder
  • Stiffness and loss of motion in your shoulder, especially after periods inactivity
  • Difficulty sleeping on your side
  • Swelling at the top and front of your shoulder
  • Clicking or grinding sensation

What Causes AC Joint Osteoarthritis of the Shoulder?

The most common cause of ACJ arthritis is overuse. This may be due to wear and tear over time, as cartilage becomes weaker and more brittle as we age. It can also be the result of repetitive actions. It is particularly common in sportspeople who participate in overhead or throwing activities or weight lifting, and in people who do overhead activity in their job.

A traumatic injury to the ACJ can also lead to osteoarthritis. The cartilage lining the joint can get torn as a result of an impact, such as the hit to the shoulder in contact sports, or a heavy fall on an outstretched arm. If untreated, this can lead to degeneration of the bone and other shoulder problems.

Treatment for AC Joint Osteoarthritis

Capital Orthopaedics is highly experienced in diagnosing and treating ACJ arthritis.

Diagnosis by our consultant surgeons will include a physical exam and interpretation of scans – including an x-ray or CT scan to view bone damage, and an MRI or ultrasound scan to assess any soft tissue damage.

Treatment options are dependent on the extent of the damage to your joint and your level of activity.

Nonsurgical treatment

You can relieve some symptoms of ACJ arthritis with non-steroidal anti-inflammatories (NSAIDs) such as ibuprofen, along with rest and ice.

Capital Orthopaedics offers the following treatments:

  • Physical therapy: our physiotherapists offer tailor-made programmes to help you regain full range of motion, reduce stiffness and build strength around your shoulder.
  • Injections: steroid injections can reduce swelling, alleviate stiffness, and offer temporary pain relief in the AC joint.



Resection arthroplasty

This ACJ surgery involves removing a small section of the end of the clavicle and acromion, creating space in the joint. As the bones heal, scar tissue will form, enabling movement, but stopping the bones rubbing together. The operation is carried out by one of our renowned orthopaedic surgeons using arthroscopic (keyhole) surgery.

Rehabilitation focuses on regaining full range of motion, and begins as soon pain allows (usually 24 hours after surgery).

For the first four to six weeks after surgery, your physiotherapist will concentrate on restoring range up to 90 degrees, and after six weeks, take you to full range of movement and strength.

Full activities should be achieved by three months.

Book an Appointment with Capital Orthopaedics

Based in three central London locations, our expert team is led by renowned orthopaedic surgeon Simon Moyes and offers pioneering surgical treatment, specialised physiotherapy programmes, and the very latest in injection therapies.


Other shoulder conditions we treat

Biceps Tendonitis

The tendons that attach your biceps muscle to your shoulder (glenohumeral) joint can get damaged as a result of lifting heavy objects or through repetitive actions. The symptoms of biceps tendonitis are a deep throbbing ache at the front of your shoulder joint and a feeling of weakness. Treatment includes steroid injections and physiotherapy. Surgery is usually only required for a complete biceps tendon tear, or if there are other shoulder problems.

SLAP Tears

The ring of rubbery cartilage in the socket of your shoulder joint can get torn as a result of an impact, a wrenching action or overuse. Symptoms include: locking or grinding in your joint, pain lifting or raising your arm overhead, shoulder weakness, feeling of instability. SLAP tears can be treated with steroid injections and physiotherapy. Detached or badly torn labral cartilage may require arthroscopic surgery.

Frozen Shoulder

The connective tissue surrounding your shoulder joint is called the shoulder capsule. It can get inflamed and thickened, resulting in stiffness, pain and loss of range of motion. Capital Orthopaedics offers hydrodilatation injections – high volume injections of local anaesthetic, saline and steroid – to stretch the capsule, reduce inflammation and manage pain. If symptoms persist, arthroscopic surgery may be needed.

Dislocated Shoulder

Your upper arm bone (humerus) can get pulled out of its socket (glenoid) by being forcefully twisted or in an impact. If the tendons and ligaments are badly damaged, it may lead to chronic instability, repeat dislocations and osteoarthritis. Treatment includes physiotherapy and surgery to improve stability and repair damage to the structures of your shoulder.

Rotator Cuff Repair

The tube of tendons in your shoulder joint can be damaged by forceful twisting of your arm, an impact to your shoulder or repetitive movements. It causes pain, weakness and inflammation in your shoulder. Capital Orthopaedics offers physiotherapy and injection therapy to reduce inflammation and stimulate healing. Arthroscopic surgery may be carried out to resolve ongoing rotator cuff problems.

Scarf Test for AC Joint - Shoulder Exam

Learn how to do the scarf test for the AC Joint from Simon Moyes, leading Orthopaedic Surgeon in London.

Book an Appointment with an Orthopaedic Specialist

The Capital Orthopaedics team is made up of highly experienced medical professionals – from Mr Simon Moyes, the renowned orthopaedic consultant surgeon, to physicians, nurses, anaesthetists and physiotherapists.
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