Arthroscopic Distal Clavicle Excision

Arthroscopy is a minimally invasive surgical technique used in the treatment of sports medicine injuries. It involves the use of a fiber-optic camera, which we place into a joint through a small incision in order to visualize ligaments, cartilage, and soft tissue. Through another small incision, we can then use small instruments to remove or repair broken or damaged tissue.

Shoulder arthroscopy with a distal clavicle excision is the term used to describe surgery done for patients with a painful acromioclavicular joint (AC joint). The collarbone (clavicle) meets with the tip of the shoulder blade (scapula) and forms the AC joint. In most patients, the AC joint has arthritis but is not painful. Sometimes this joint can become painful due to the arthritis. In order to alleviate the pain, the bone making up the AC joint is removed arthroscopically. This procedure is often done in conjunction with an arthroscopic subacromial decompression for treatment of shoulder impingement.

This procedure involves removing the end of the clavicle, which forms the AC joint. This will alleviate pain and loss of motion caused by impingement and arthritis. Your body will produce scar tissue where the bone is removed, and your pain will resolve since there is no longer bone rubbing on bone. This procedure is often performed with a subacromial decompression.

Post Operative Instructions:

SLING/MOVEMENT

  • For the first 3 weeks after surgery, you must wear your sling at all times including while you are asleep. You may only remove the sling to shower and to perform range of motion exercises for your elbow.
  • You should flex and extend your elbow 3 to 4 times a day to prevent stiffness. Do not move your elbow away from your body as this may damage the repair.

ICE

  • An ice machine will be provided to you prior to your surgery. This will help decrease swelling and pain after your surgery. Use the ice machine as much as possible when you get home at intervals of 30 minutes on and off. You should keep the ice machine for approximately two weeks. Do not use the ice machine while you are sleeping.

MEDICATIONS

  • An injection of local anesthesia was injected into your shoulder after the completion of the operation. This medication will wear off in 5 to 6 hours. Therefore, begin taking the pain medication (e.g. Vicodin, Percocet, etc) immediately when you get home. This will prevent you from having severe pain. Take the pain medication every 4 hours until you go to bed.
  • The day after surgery you can take 600 mg of Ibuprofen (Advil/Motrin) every 6 hours to help with inflammation and pain. This medication will help cut down the use of narcotic-based pain medication. However, if you still have pain after taking the Ibuprofen, continue taking the pain medication every 4-6 hours as needed.
  • A sleeping medication (e.g. Ambien) is also provided to help you sleep at night. Take one tablet 30 minutes before you plan to sleep.

DRESSING/BANDAGES

  • Your shoulder dressing is waterproof. You may shower the next day after surgery. Two days after surgery you may remove the entire dressing. Gently wash the wounds with soap and warm water and towel dry. You may then cover the incisions with band-aids until your post op visit.
  • Do not take a bath or submerge your shoulder in water until your incisions are checked at your first post-op visit.

APPOINTMENT

  • Please call the office prior to, or immediately following, your surgery in order to schedule a postoperative appointment. This should be scheduled 7-10 days after surgery. At that visit your stitches will be removed and you will be given a prescription to begin physical therapy.

If you have any questions or concerns, please contact our assistant at (310) 659-2910 extension 3048.

Download the postoperative instructions for your procedure (PDF) 

Recovery Timeline:

Day of surgery: Arrive one to two hours prior to surgery. Procedure will take approximately one to two hours, and recovery time is one hour. For immediate post-op instructions, download the instruction sheet.

One week post-op: First follow-up visit with Dr. Snibbe/Jennifer. Stitches will be taken out, and you’ll get to see your pictures from the surgery. Continue icing two to three times a day (more if needed). Continue with sling for three weeks from date of surgery at all times except when bathing. Physical therapy will be prescribed, but you won’t start PT until three weeks after surgery.

Four weeks post-op: Second follow-up visit. By this time you should have been out of the sling for a week and begun physical therapy. Physical therapy will begin with gentle range of motion exercises and will progress as tolerated (this is determined by the physical therapist). Physical therapy will continue. Stiffness and mild discomfort at night and with certain motions is common at this stage of the rehab process.

Eight weeks post-op: Third follow-up visit. Range of motion and strength testing. If additional range of motion or strength training needed, continue physical therapy to work on rotator cuff strengthening. Pain should be mostly resolved at this point.

Twelve weeks post-op: Fourth follow-up visit. Range of motion should be full/normal, patients should feel stronger and have very little pain if any, near to full recovery expected at this time; some patients will require additional 4 weeks of physical therapy to continue with rotator cuff strengthening exercises.




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