Severe grade 5 ac joint dislocation and glenoid fracture

Hi.i am a competitive cyclist and triathlete and was involved in a nasty cycling accident while out on a training ride in april of this year.I sustained a severe grade 5 ac joint dislocation and undisplaced glenoid fracture in my right shoulder.
I underwent surgery and my dislocation was treated with fixation of a hook and plate which was then removed surgically 12 weeks later. I also had to have a third operation which was a arthroscopic ac joint excision as x rays showed that the ac joint was pretty rotten!!
The problem is i am a sportsman by nature and profession as i work as a self employed swimming teacher.I have recently returned to work part time but i am still experiencing considerable pain in the shoulder and my range of movement is still somewhat restricted.
Can you tell me what the long term prognosis is for an injury of this kind considering the nature of my work etc?
What is the likelihood of any recurrent dislocations and the chances of arthritis setting in later in life? And the realistic percentage range of movement i will get back?
I maintain my physio exercises on a daily basis but my arm still aches . Any information would be much appreciated.
Cheers Martin

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Severe grade 5 ac joint dislocation and glenoid fracture

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Nov 08, 2008
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long term prognosis
by: Bart - SII

Obviously, your shoulder has been through a lot. The displaced glenoid fracture, even with perfect fixation and restoration of the articular surfaces is going to have some arthritic changes. I would guess that you should continue to get better over the first year after surgery, but will likely have some permanent motion loss - 5-15 degrees in your end ranges of motion.

Future dislocations will likely be dependent upon your activities, but if you maintain your shoulder strength, you shouldn't be any more prone to shoulder dislocation than normal with normal activities (barring any more cycling accidents).

Scapular stabilizer strengthening as well as flexibility exercises are going to be important to maintain.

Bart

Apr 29, 2009
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Your shoulder
by: Anonymous

I would think hard about having the surgery. You see I had my right shoulder replaced about 25 yrs ago and although the operation went just fine. I went through a lot of pain for a couple of years (even though the doctors said that I would not). Now I have damaged my left should in a mountain bike accident. Doctor said that I can have the operation (and risk infections) or let it heal naturally. I opted for it to heal naturally. So far it is going well. Takes about 2 to 3 months. It is better than risking surgery where you might wind up with further complations.