Shoulder Separation Surgery Recovery: Research Shows You Don't Need Surgery

POSTED ON 4/20/2018 IN Shoulder BY Christopher Centeno

When I was in medical school, I crashed a motorcycle and separated my shoulder. I was told back then that I could get surgery, but I didn't do it. Why? I was concerned about shoulder separation surgery recovery. Now, 30 years later, I'm glad I didn't have the surgery. Now I feel vindicated that the latest research backs up my decision.

What Is the AC Joint?


The acromioclavicular (AC) joint lives in the shoulder region. If you follow your collarbone (the clavicle) on the top of your shoulder, you'll come to a prominence in the bone just before you reach the shoulder. This is your AC joint. As you pass over the AC joint, you will reach a shoulder bone called the acromion. So the joint is situated between the clavicle and acromion; hence, the acromioclavicular joint. The AC joint can become dislocated or separated when it is injured, and while a dislocation sounds ominous, conservative measures and a lot of time are usually sufficient for healing. However, when high-grade dislocations occur, those that involve not just the bone but also tears in the ligaments, surgery is usually recommended. The surgery for this condition usually involves bolting together the unstable joint. There are two problems with this approach. First, the joint is designed to give as you move and bolting it together gets rid of that normal joint flexibility. In addition, the shoulder separation surgery recovery time is not insignificant. Another type of AC joint surgery is decompression. When the joint has arthritis, it can place pressure on the rotator cuff tendons underneath. To try and help this issue, surgeons will try to take off the bone spur. Take a look at my brief video below to see what an AC joint decompression surgery looks like:


  


So is AC joint surgery for a separated shoulder the right solution? One study suggests that even for the high-grade (levels III–V) dislocations, surgery may be no better than doing nothing. Let's take a look.

Surgery for AC Joint Dislocation No Better than No Surgery


The purpose of the new study was to investigate the outcomes for patients with high-grade acromioclavicular joint dislocation, comparing those who had surgery to those who did not. This means that they studied the worst patients. The ones who usually get offered surgery. The new research paper was a meta-analysis consisting of 954 patients across 19 different studies. The results? Researchers found no clinically significant positive difference in the group that underwent surgery for their AC joint dislocation, and no differences were found in function between the two groups. However, the group that opted for conservative management with no surgery were able to get back to work faster and had fewer complications and infections. This means that shoulder separation surgery recovery lagged behind, and included complications not experienced by the patients that did not have the surgery! We can add this to the growing mound of orthopedic surgeries in which we have to ask, Why in the world are we doing this surgery? Other studies have also suggested surgery for AC joint dislocation is no better than no surgery, so this study adds further confirmation and adds to the burgeoning body of literature showing that so many orthopedic surgeries are unnecessary.

The Orthopedic Surgery Slide Continues


If you read this blog, you know that I've highlighted so many common orthopedic procedures that have been shown to be no better than fake surgery. Why? These surgeries never made much common sense in the first place. For example, cutting out a piece of the knee meniscus shock absorber means that there is less cushion for the joint. Or fusing the spine just means that the levels above and below this area will sustain more force and cause these areas to break down more quickly. The upshot? You don't need surgery for even a high-grade AC joint separation. I'm a living testament to that fact, as 30+ years later I have no issues with heavy weight lifting. I'm so glad I didn't have somebody bolt my shoulder joint together. Looks like if I did, I wouldn't have benefitted and might have had some awful surgical complication!  

  1. outcome
  2. rehab
  3. shoulder
  4. surgery

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