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Help with my AC separation

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I am a 54 year old ER doc. I sustained a Grade III AC separation four days ago in a cycling accident. I saw my orthopedist here in the Plano area, and I told him that I wanted surgery to be able to be back to ride in the Livestrong bike ride Oct 26 in Austin. Also I was a pro level tennis player in my athletic days so I want to preserve the possibility to play competitive tennis in the near future as well.

My research showed that the Arthrex Tightrope or Graftrope would be the procedures of choice.

Am I correct in thinking that I need this surgery to get the best possible quick result, or is there something about it that I am ignorant about.

Also, if I do have the surgery, can you advise me on the highest level of rehab that will give me the fastest, but surest, results from this recovery. He is wanting me to be in a sling and swath for 4 weeks post op. This will inhibit my ability to do medical procedures in the ER during that time. If necessary then I will do it, but if this is old school then I want to know about it and see what is the most current method of rehab.

Thanks

Jeff Schaffer, MD

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The Arthrex tight rope absolutely sucks. Reported failure rate is 40% Could you believe it? And they still push this stuff.

Two strands of number five fiberwire (also made by Arthrex) through drill holes in the clavicle will leave you will a much more stable repair, and allow you slingless, full active motion the day after your surgery, and return to MX before three months.

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I talked to several Arthrex reps who told me that the button on the Tightrope had been redesigned recently. I am not sure if this has made a difference in the outcomes or not. Or if the new Graftrope is better designed?

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Don't you just love those smiling college kids with the Brooks Brothers suits that their Mom and Dads just bought them.

Its exciting to be the first one to have a new gizmo.

A 54 year old doctor should know from his years of practice to most certainly not be the first guy in town to do or have done a brand new device or procedure.

I was told in medical school, and my residency always be one or two fads behind the "cutting edge". And I have. That one of the reasons I only pay 5000/year in malpractice premiums in a state where most orthopaedic guys pay 50,000/year.

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Dr. Mark,

I also separted my shoulder recently and am considering surgery. What technique do you prefer if you don't recommend the Tightrope? Is there a name for it?

Thanks

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I hate the tight rope. I have seen too many of them fail. I do it the old fashioned way by placing the same heavy sutures that go underneath the coracoid process and brought through drill holes in the clavicle.

This way is a bit harder for the surgeon, but allows a stouter repair that enables full motion of the shoulder starting the day after surgery.

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Not sure if this is frowned on or not, but I seperated my shoulder grade 3 about 4 months ago in a DH Mtn. bike accident. I did not opt for surgery and was back on a bike in 3 weeks with heavy rehab. I was dropping and jumping stuff 5 weeks in. The only limitatin I have foud myself to have is I cant do push-up's without pain. I do have some soreness some times after long Mtn. Bike rides. MX does not bother it at all?

Dr. Mark do you have any opinions on this? I am not that worried about the physical apperance of the lump in my shoulder.

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I usually treat grade three seperations without early surgery, too. At least two thirds of people can do fine without the operation.

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