What is AC joint reconstruction?
The acromioclavicular (AC) joint sits at the top of the shoulder, held by ligaments between the collarbone and the shoulder blade. A high-grade separation tears these ligaments, allowing the collarbone to ride up and creating a visible step and loss of strength.
Reconstruction restores the collarbone to its correct position and rebuilds the torn ligaments — using strong sutures, a device, or a tendon graft — to hold it there while healing occurs.
Who is it for?
- High-grade separations with significant displacement.
- Persistent pain or weakness after a separation.
- Active patients and overhead or manual workers.
- A visible deformity that is functionally limiting.
Lower-grade separations recover well without an operation. Reconstruction is reserved for high-grade injuries or those that remain painful and weak despite rehabilitation.
How the procedure works
Using arthroscopic assistance, the collarbone is reduced back to its correct position relative to the shoulder blade and held with strong sutures passed around or through the bone, often reinforced with a tendon graft to recreate the torn ligaments. The graft provides durable, biological stability as it heals.
Recovery timeline
Protect
A sling protects the reconstruction; gentle movement within limits to avoid loading the repair.
Restore motion
Progressive range of motion as the ligaments and graft heal.
Strength & return
Strengthening, then a graded return to sport and heavy activity.
Risks & outcomes
Reconstruction reliably restores the position of the collarbone and the strength of the shoulder in well-selected patients. The main considerations are protecting the repair during healing and a small chance of some loss of position over time. Risks such as infection, stiffness and clots are uncommon and actively managed.