Acromioclavicular (AC) Joint Reconstruction
Acromioclavicular (AC) joint reconstruction is performed in the case of a severe shoulder separation. This frequently happens in hockey and football players. Cyclists who fall off their bike often sustain these injuries as well. If the collarbone is displaced, it may be repositioned to restore normal positioning and function. Traditionally, this was done through a large incision on top of the shoulder. Drs. Joshua Dines and David Dines are amongst a small group of surgeons who can perform this technique arthroscopically, which minimizes complications associated with the procedure. During surgery for a shoulder separation, the AC joint is restored by using a tendon graft to reconstruct the ligaments that attach the coracoid to the clavicle (collarbone). The surgery is done on an outpatient basis. Physical therapy typically starts about a week after the surgery.
PRP injections are prepared by centrifuging the patient’s own blood to concentrate the platelets. They are then injected into the injured area containing the damaged or abnormal tissue. PRP injections are prepared and injected by Dr. Dines right in the office. Dr. Dines typically uses PRP to treat overuse injuries, most commonly those affecting tendons.
Frozen shoulder (adhesive capsulitis) is a condition in which the tissues of the shoulder joint become inflamed, resulting in stiffness, restricted motion, and pain in the shoulder. Scar tissue (adhesions) forms, causing tightening in the shoulder capsule. Many patients report increased pain at night or during cold weather; and the disease can be extremely debilitating for some, affecting patients’ abilities to sleep and function on a daily basis. symptoms tend to begin gradually, with pain during movement and limited range of motion. Although the pain may diminish over time, the shoulder may become increasingly stiff, significantly limiting range of motion. Eventually, range of motion may begin to reappear over the course of a few months to years. Patients with a history of diabetes, thyroid disease, Parkinson’s disease, stroke and heart diseases are more at risk for frozen shoulder. Frozen shoulder is also more common in paitents who have had their shoulder immobilized for prolonged periods of time.
Drs. David Dines and Joshua Dines usually treat frozen shoulder first using nonsurgical options to manage pain and restore motion in the shoulder. Non-steroidal anti-inflammatories, such as ibuprofen, can be used to reduce pain and swelling. If pain persists, Dr. Dines may recommend steroid injection into the shoulder joint to reduce pain. Physical therapy and stretching exercises are also recommended to help regain mobility in the shoulder. If symptoms continue to persist and the condition does not improve, Dr. David Dines and Dr. Joshua Dines can perform manipulation of the shoulder under anesthesia to remove adhesions that have formed. Arthroscopic surgery, in which the doctors use a small camera through small incisions in the shoulder, can also be performed to remove scar tissue in the joint with minimal invasiveness. Recover from surgery typically takes 6 weeks to several months, during which time physical therapy is recommended.