Acromioclavicular (AC) Joint Seperation Surgery

The acromioclavicular (AC) joint is the joint between the collarbone (clavicle) and the extension of the scapula (acromion), often referred to as the shoulder’s small joint.

The AC joint is held in place by extremely strong ligaments, called coracoclavicular ligaments. These consist of two separate ligaments, the trapezoid and conoid ligaments. They are the most important structures that keep the AC joint in place, especially in an up and down direction.

AC joint injuries are common in athletes such as cyclists, skiers, and football players. These injuries usually occur by falling onto the upper part of the shoulder.

When you fall onto your shoulder, one possible injury is the tearing of these two ligaments, causing your collarbone to displace upward from the AC joint.

AC joint injuries are graded according to the severity of the injury.

In grade 1 and 2 injuries, the ligaments are strained and slightly damaged, causing moderate shoulder pain. These injuries generally heal with non-surgical methods like ice, rest, medications, and temporary use of a sling.

Grade 3 and 4 injuries denote more severe damage to the ligaments. Surgery is required to eliminate shoulder pain and restore shoulder function in those who sustain these injuries.

The aim of this surgery is to reposition and secure the collarbone back to its original location in the joint. To fix the joint in the correct position, I primarily use a very robust rope system called tightrope, which has buttons on both ends.

If the injury is very fresh, this surgery can be performed arthroscopically, i.e., minimally invasively.

After surgery, it may be necessary to stay in the hospital for one night for pain control. The arm sling is used for about 2 to 3 weeks.

The surgery gives quite good results if it is performed within 3 weeks after the injury. In later cases, the success chance of the above procedure is low, and it is necessary to review other reconstruction surgery options.