Anybody had (or refused) AC shoulder surgery?

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Anybody had (or refused) AC shoulder surgery?

27 posts & 17 voices | Started 3 months ago by BigJohn | Latest reply from BigJohn

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BigJohn - Member

I fell off about 3 weeks ago and separated my shoulder (Acromioclavicular joint injury). I saw the ortho surgeon at the hospital who x-rayed it and diagnosed it a type 2. But because of all the activities I do (biking, windsurfing and putting up kitchen cabinets) and my advanced age (58) he referred me to a specialist shoulder surgeon. He mends Welsh rugby players etc. This is all at the notorious (but remarkably excellent) Stafford Hospital.

I saw the shoulder consultant surgeon yesterday. He said "it's between a type 2 and a type 3" (and I now know what all this means, thanks to Bing and UpToDate) but what surprised me was how eager he was to cut me open and screw a strap in there.

He told me that in 12 months it was unlikely to be any difference between the surgery option and the "leave it alone" option. I've got full range of movement, hardly any lump, and am getting on with most things. Should be going on a gentle ride over Cannock Chase (1-armed up the steeper hills tho) on Sunday. But if I went for surgery I would be looking at a 3 mth break from windsurfing. Even if I didn't get to meet Mrs A.

I really don't know what I should do.

Posted 3 months ago #
clubber - Member

iirc anotherdeadhero from here had the same choice recently and decided against surgery. maybe worth emailing him.

Posted 3 months ago #
Surrounded By Zulus - Member

Do they screw a strap on or do they move one of the other ligaments in your shoulder to replace the damaged one?

A site that may be of interest to you http://www.shoulderdoc.co.uk/article.asp?article=60

Posted 3 months ago #
BigJohn - Member

From what I was told they have stopped dicking around with the ligament at the end, it causes arthritis. They put a strap over your collarbone and screw the front to the chestbone just to stop it sticking up.

Posted 3 months ago #
Stoatsbrother - Member

I've skied with a Vet who has an unrepaired 1.5cm drop at his ACJ and does ok

Posted 3 months ago #
Lady Gresley - Member

I had this injury about 16 years ago, and wimped out of the operation at the last minute. (The solution for mine was to use a piece of muscle from the upper arm, and tie it through a hole drilled in the collar bone.)
I had pain on and off for a few years, and discovered trying water skiing about a year after was not a good idea.
It's pretty strong these days, but just occasionally it feels like it's moved into the wrong place, but a bit of arm-waving-around seems to solve that problem.

Posted 3 months ago #
cinnamon_girl - Member

I have an AC separation from falling off my bike in September and am still waiting for the date of an op to have screws put in. It's been x-rayed and MRI'd last month.

Time has certainly made life easier but still can't lift anything heavy. Am riding though and have had a few falls.

Mine is compounded by an old collar bone break that started giving me pain even before the accident. Consequently, I am lop-sided/round-shouldered.

It's very tempting to ignore and not have the op but totally understand what you're saying re the age thing.

Tough decision but good luck with whatever route you go down.

Posted 3 months ago #
BigJohn - Member

Not surprising you said no to that one, LadyG. I went to the doc today as they have a physio in the practice who I'm getting referred to so I should get some strength compensatory exercises.

CG being a windsurfer I've got quite a bit of upper body strength (form an orderly queue, ladies...) so I'm lifting stuff fine already. And I can nearly open jars of pickled onions on my own.

Posted 3 months ago #
leonthepro - Member

I had exactly the same thing in November 2010 and the consultant said it was completely upto me which way to go and that I should go away and research it and then let them know. I found a study from US where they took x number of american football players with the injury and compared the results of those that had surgery and those who didn't x number of months on. The result was that it didn't make any difference in terms of strength or movement with the only differing factor was recovery time. As you would expect those of didn't have surgery recovered quicker.

I also found my local nhs physios to be next to ussless as they had never come across the injury before. In fact they googled it while I was in the examination room. So again I managed to find a physio program which really helped and sped up the recovery. If you want a copy I can dig it out.

So 14 months my shoulder is as strong as ever with no pain and full ROM.

Posted 3 months ago #
vinnyeh - Member

I did both my shoulders in my mx racing days, 30 odd years ago (50 now)- both about a 1.5 cm drop. Memories a bit hazy now, but I think I was told an increased risk of arthritis in old age, versus a painful op and 3-6 month recovery.
Everything is still largely ok, theres a definite restriction in reaching behind me- I'm useless at scratching my back for instance, but that's about it for effects so far.

Posted 3 months ago #
Alpha1653 - Member

I did mine about this time last year and it took about 6 months to get properly better, and that was only after I chinned off the physic exercises and set myself a challenge of 3000 press ups in 30 days. Mine was excruciating for about 1.5 months and never had surgery as I was in Nepal. If you're getting back to normal activities after only 3 weeks, I'd say you're recovering pretty quickly compared to me (and I'm considerably younger than you, no offence!) so surgery sounds unnecessary.

That said, I'm no doctor or surgeon and have no clue about stuff like that so you should probably ignore what I've said and discuss with your doctor!

Posted 3 months ago #
Surrounded By Zulus - Member

I also found my local nhs physios to be next to ussless as they had never come across the injury before. In fact they googled it while I was in the examination room. So again I managed to find a physio program which really helped and sped up the recovery. If you want a copy I can dig it out.

I dont believe for one second that a qualified physio hadn't came across a separated AC joint. And it is simply not possible that they wouldnt know what the injury was. Acromion - clavicle - joint - separation. Does exactly what it says on the tin. They may have looked up the grade of injury, and the local protocol for treating it, but certainly would not be looking up anything more basic than that.

Posted 3 months ago #
BigJohn - Member

I'll just pretend I haven't hurt it and carry on doing what I'm doing. But I'm not doing 100 press ups a day for anybody.

Although I do remember saying something like that about bread and cheese before I started the iDave thing.

Posted 3 months ago #
PJM1974 - Member

I'm about to have a modified Weaver Dunn surgery in about ten days time...

I ruptured my shoulder ligaments after an over the bars last April and was in a lot of pain for a month or so (I should add that I got back on my bike within two weeks and instantly regretted it).

I've three months of no mountain biking ahead of me. It won't be long before I start hallucinating and going through the DTs.

Posted 3 months ago #
BigJohn - Member

Ugh. I just looked up modified Weaver Dunn on Bing. Maybe I'm just over sensitive but I couldn't face clicking the animation.

I'm definitely going to go into denial about the whole thing now.

Where can I get a kettlebell - quick?

Posted 3 months ago #
FunkyDunc - Member

Mrs FD is an orthopaedic surgeon, and we were speaking about shoulder surgery only a couple of weeks back (as to whether she would specialise in it) She was saying that shoulder surgery is only really done by very specialist specialists and you should avoid having it done at all costs as the outcomes are not great.

But then she was talking in general, not about specifics or indeed maybe anything to do with what you have wrong etc etc.

Posted 3 months ago #
PJM1974 - Member

Well, the guy doing mine most definitely is a specialist. I've been checking up on his work and credentials online.

It's fascinating what they do - I'm as squeamish as the next person, but I can't wait to try out my bionic shoulder. I haven't been able to swim, lift my bike or rock climb since last April and I really want to get full mobility back.

Posted 3 months ago #
scruff - Member

BJ, I have just consulted the top consultant, his opinion is that the only course of action is complete amputation above the clavicles.

Posted 3 months ago #
iDave - Member

Who is Mrs A?

Posted 3 months ago #
snakebite - Member

euthanasia.

Posted 3 months ago #
BigJohn - Member

But wouldn't my cravat fall off then Scruff?

Posted 3 months ago #
geoffj - Member

I had a 2/3 18 months ago. No surgery was offered, and I wouldn't have taken it if it was. I had discomfort for a couple of months, but other than a boney lump which spoils my symetrical adonis-esque physique, there are no long term issues.

Being cut open should be avoided at all costs IMHO.

Posted 3 months ago #
BigJohn - Member

She's C Diff's sister. MRSA.

Posted 3 months ago #
ianv - Member

I did mine before christmas and have had all sorts of shoulder injuries over the last year or so.

Personally, if you have decent movement I would not go for surgery. Biking is fine now with mine as are the sort of movements you get from windsurfing (straight on pulling is fine, it is only the more contorted rear movements that cause problems). If you live with it you will be able to do most things OK until it gets full recovered whereas if you get the op you will do nothing for quite a while, lose muscle whilst in a sling and then need to rehab again to get things back on track (a month in a sling needs a long time to get back to where you were prior to wearing it).

Posted 3 months ago #
BigJohn - Member

Having read all the "don't do it" posts on here I have concluded that the surgeon knows that the best way to heal these things is to work the shoulder really really hard. But of course people are reluctant to keep going through the pain.

So he conned me into thinking there was a safety net of surgery which was always available if I needed it, so I wouldn't be held back.

So I spent all day yesterday building up my bike (I sent the soul away to be powdercoated, thinking I wouldn't be needing it for a while - matt black, btw, very nice too) and all this morning riding over Cannock Chase.

Excellent result - no bad reaction at all - although I was petrified I might fall off on the ice and really hurt myself.

Posted 3 months ago #
mrh86 - Member

I have been in the same situation.

I did mine skiing in July 2010 while in NZ. Came back and had an appt with at local hospital. decided not to have surgery. 6 months down the line I wasn't happy with it. I had paid for some private physio at manchester shoulder physio, who work closely with a few surgeons who do all the rugby injuries in the area.

I made a choose and book appointment through local GP to see the surgeon behind the shoulderdoc website mentioned above (in his NHS clinic). Had a LARS ligament repair late July 2011.

Shoulder is much more stable now than before. No difference in mountain biking, but now able to do press-ups/bench press again(which I wasn't able to do prior to surgery)

They also removed a cm from the end of my clavicle, therefore preventing future bone-on-bone wear (OA/"wear and tear arthritis")

Posted 3 months ago #
BigJohn - Member

I'm not worried that I can't do press-ups, although there is one particular domestic activity where I need to support my weight through my arms...

Posted 3 months ago #

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