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Shoulder Surgery

SIX

Shoulder Surgery

Acromioclavicular Joint (ACJ) injuries,

or a separated shoulder, is an injury

that can occur in contact athletes,

whether they come into contact with

another player as in rugby, or with the

ground when coming off a bicycle at

high speed.

Injuries are classified into 6 types; the

less serious types 1,2 and 3 are treated

in a sling, analgesia and physio.Type 3

may need surgery if it continues to be

painful. The more displaced injuries,

types 4, 5 and 6 require early surgical

reconstruction.

RM is a 30-year-old male who is a very

keen triathlete; he was on a training

ride when he came off his bicycle trying

to avoid a car. Landing on his shoulder,

he suffered a type 5 ACJ injury. After

consultation, we decided to proceed to

surgical stabilisation to allow him early

recovery and a rapid return to sport.

The Surgilig™ is inserted to reconstruct

the coracoclavicular ligaments, that

usually stabilise the end of the clavicle

through a mini-open incision. It is made

of double-braided polyester with a

weave design that acts as a scaffold

encouraging tissue in-growth. Surgilig™

is looped around the coracoid, and then

passed behind the clavicle where it is

secured with a 3.5mm bicortical screw

and washer.The Surgilig™ implant has

one hard loop for screw fixation, and

one soft loop which surrounds the

coracoid.

Following surgery, the patient uses a

sling for the first couple of weeks to

allow tissue healing, and rehabilitation

is started at two weeks. Full training is

started at 12 weeks and full contact

sport at 5 months. RM regained a full

range of movement by 6 weeks and

was undertaking cycle and swim

training at 12 weeks.

We have recently published the largest

series of ACJ reconstructions using the

Surgilig™, with a 94% patient satisfaction

rate and early successful return to sport.

Carlos, AJ, Richards, AM and Corbett, SA

(2011), Stabilization of acromioclavicular

joint dislocation using the ‘Surgilig™’

technique. Shoulder & Elbow, 3: 166–170.

Mr Andrew Richards and Mr Steve

Corbett are specialist shoulder and

elbow surgeons who have a particular

interest in sports injuries.They provide

a team approach to the management

of their patients as part of the Fortius

Clinic at London Bridge Hospital.

Rebuilding

Separated

Shoulders

www.fortiusclinic.com

Reconstruction of the acromioclavicular joint using the Surgilig™

Mr Andrew Richards

Consultant

Orthopaedic Surgeon

BSc (Hons) MS FRCS (Tr&Orth)

Guy’s and St Thomas’

NHS FoundationTrust

Secretary: Hollie Jones

T: 020 3195 2431

F: 020 3070 0106

[email protected] www.fortiusclinic.com

Mr Steven Corbett

Consultant Orthopaedic

&Trauma Surgeon

BSc PhD FRCS FRCS (Tr&Orth)

Guy’s and St Thomas’

NHS FoundationTrust

Secretary: Sally Hargreaves

T: 020 7234 2689

F: 08717 335 056

[email protected]