ASD/ACJ Excision

ASD and/or ACJ Excision

Indications:

• Evidence of inflammation or scuffing on the under surface of the acromion, coracoacromial ligament & on the bursal side of the rotator cuff (i.e. presence of impingement

Procedure:

• Removal of bone from the acromion & partial resection of the coracoacromial ligament
• The AC joint remains intact unless excision is indicated, the distal clavicle and part of the acromion is removed
• The superior AC ligament remains intact so that the joint remains stable

Protocol

	Post op
On Discharge from Hospital	Immobiliser (This should be removed within the first 2-3 days Post-op Exercises on discharge  Active (assisted) glenohumeral movement in all planes Teach postural awareness and scapular setting
Out patient Physio Levels 1-3 Exercises Levels 1-3 Exercises   Levels 1-3 Exercises	Begin isometric strengthening (progress using pain & ROM as the limiting factor) Rotator cuff strengthening Address posterior capsular tightness (sleeper stretch and cross-shest adduction) Over zealous physio or repetitive sustained overhead activity could lead to delayed healing & pain

Milestones	Full recovery can take 6-9 months. Expect 80% improvement by 3 months.
Caution	Any significant increase in pain or decrease in ROM arrange a clinic appointment for a review.

 
See Post-Operative Exercises

 Return to functional activities

Return to work            Sedentary job: as tolerated

                                    Manual job:      may need to modify activities for 3 months

 Driving                        1 week

Swimming                   Breaststroke:   as able

                                    Freestyle:          12 weeks

Golf                             6 weeks

Lifting                         as able

Racquet sports            Avoid repetitive overhead shots for 3 months

 

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