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An acromioclavicular (AC) joint separation is a common injury among active individuals. This occurs when the clavicle (collarbone) becomes detached from the scapula (shoulder blade). It is typically caused by a direct impact to the shoulder's tip or a forceful blow, often during contact sports. Athletes like football players and cyclists, particularly those who fall over handlebars, are especially prone to AC joint separations.

AC joint separation repair is performed to treat a significant injury to the acromioclavicular joint, where the collarbone (clavicle) meets the highest point of the shoulder blade (acromion). This injury, often caused by falls, sports trauma, or direct blows to the shoulder, leads to pain, instability, and impaired shoulder function. Surgical repair is usually recommended for moderate to severe separations (Grade III and above) or when non-surgical methods fail to restore strength and stability, particularly in active individuals or athletes.

See a doctor if you experience shoulder pain, swelling, visible bump or deformity on top of the shoulder, loss of range of motion, or weakness following a fall or impact injury. Mild AC separations may be treated conservatively, but persistent pain or visible deformity needs evaluation by an orthopaedic or sports medicine specialist for possible surgical repair.

Preparation begins with X-rays and/or MRI to assess the severity of the separation and damage to surrounding ligaments. A physical exam will evaluate strength and function. Prior to surgery, patients undergo pre-anaesthesia clearance and routine blood tests. You’ll be advised to fast for 6–8 hours before the procedure. Instructions will be given on medications to stop, sling usage, and post-op recovery expectations.

AC joint repair can be performed via open surgery or arthroscopically, depending on the severity of the injury and surgeon’s preference.

Ligament Reconstruction:
Torn ligaments are reconstructed using grafts (synthetic or from your own body) to stabilise the clavicle to the coracoid or acromion.
Clavicle Stabilisation:
Screws, sutures, or tightrope fixation devices are used to reposition and hold the clavicle in place during healing.
Arthroscopic-Assisted Technique:
Minimally invasive, involves smaller incisions and quicker recovery time.

Surgery typically lasts 1 to 2 hours. Most patients go home the same day. A sling is worn for 3–6 weeks, depending on the repair. Total recovery varies but typically takes 3 to 6 months for full return to sports or overhead activity.

Infection
Nerve or blood vessel injury
Recurrent instability or loss of reduction
Hardware irritation
Stiffness or frozen shoulder
Delayed healing of the joint or ligaments

Restores normal alignment and function of the AC joint
Relieves chronic pain and shoulder weakness
Improves range of motion and shoulder stability
Enables return to active lifestyle or sports
Prevents long-term complications like arthritis or deformity

Initially, the arm is kept in a sling to protect the joint. Passive motion exercises may begin within a few weeks under supervision. Physical therapy focuses on restoring motion, strength, and gradual return to activity. Overhead or contact sports may be delayed until complete ligament healing. Full return to sports and strenuous activity is often allowed after 12–16 weeks.

AC joint repair has a success rate of 85–95%, especially in younger, active patients. Most individuals regain near-normal shoulder strength, motion, and function. Early surgical intervention in high-grade injuries leads to better outcomes and lower risk of future joint complications.