The operation for acromioclavicular pain is a very routine procedure. Overall it carries a very low risk of complication, but as with any operation this must be considered prior to the surgery. For this procedure the risks are:
Common Complications (risk between 1 in 100 and 5 in 100):
Prolonged recovery: normal recovery is around three months for this procedure. Occasionally symptoms persist after the operation for up to a year before they resolve.
Skin wound infection: this is an easily treated infection of the skin around the wounds. It settles with antibiotics and has no longlasting effect on the outcome of surgery. If wounds become red or ooze, then medical attention is needed to asses whether antibiotics are required.
Frozen Shoulder: this is a risk with any shoulder operation and the risks is highest in patients around 50 years of age. It is unusual in patients over 60 years of age or under 40 years of age. It is the result of the shoulder becoming excessively inflamed after surgery, which causes a painful and stiff shoulder. This comes on gradually after the operation and may require intensive physiotherapy or a further procedure to eliminate it.
Need for a revision procedure: this can be because poor scar tissue forms in the joint after the operation and causes persistant pain, or too little bone was removed at the initial operation.
Persistent symptoms: occasionally patients will continue to have shoulder pain and stiffness after the operation, despite technically successful surgery.
Infrequent Complcations (risk between 1 in 100 and 1 in 10,000):
Deep joint infection: this is an infection below the skin within the shoulder joint. This usually requires further surgery to eliminate the infection.
Nerve injury: this is a rare complication that can result in altered sensation, pain or weakness in the arm. If it does occur it is usually temporary and resolves over several months. Extremely rarely it can be permanent.
Fracture of the acromion (point of the shoulder): this is a rare complication that can occur due to this bone being thinned when part of it is shaved off during the operation. This may require a further operation to fix the fracture.
Extremely Rare Complications (risk of less than 1 in 10,000)
Instability of the acromioclavicular joint: this would mean that the end of the collar bone protrudes up and may or may not require further surgery.
Blood clots: this is extremely rare with keyhole surgery, but can result in a deep vein thrombosis within the calf or a clot within the lungs, known as a pulmonary embolism. To reduce these risks you will be assessed prior to the operation and may require compression calf stockings, calf pumps or blood thinning injections. We encourage early mobilistion after the operation, as this is the best way to reduce this risk.
This operation is performed under a general anesthetic and a regional anaesthetic nerve block. The anaesthetist will see you in the morning of the operation and explain about both procedures to you. If you have chronic medical conditions certain risks may be higher and this will be discussed with you at the consultation prior to a decision being made about proceeding to an operation.
Common temporary side effects (risk between 1 in 100 to 10 in 100): occasionally you may suffer from bruising or pain at the site of injections, blurred vision and sickness. This can all be treated easily and tend to subside quickly. The nerve block will cause pins and needles in your arm and hand when it is wearing off. It can also temporarily cause drooping of your eyelid (but does not affect your vision), flushing of your face, hoarseness of the voice and a feeling of not being able to take a deep breath.
Infrequent complications (risk between 1 in 100 to 1 in 10,000): occasionally the pins and needles or weakness in the arm can last weeks or months, but longterm problems are very rare. Temporary breathing and speech problems, damage to teeth or lip or tongue, sore throat, muscles pains and headaches.
Extremely rare complications (risk of less than 1 in 10,000): severe allergic reaction, permanent damage to the kidney, liver, lung, eye, brain voice box, nerves or blood vessels. All of which are extremely rare, but would require further intervention and potentially could be a risk to life.
Again it must be reiterated that overall this is a very low risk procedure, but if you have concerns please raise these with the surgeon or anaesthetist to discuss them further.
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