What is acromioclavicular (AC) joint reconstruction?

Acromioclavicular (AC) joint reconstruction is an operation to treat damage or instability in the AC joint — the small joint at the top of your shoulder where the collarbone (clavicle) meets the highest part of the shoulder blade (acromion). Injuries to this joint are common after falls or contact sports and can cause pain, loss of function, and visible deformity.

Reconstruction surgery aims to restore the normal position and stability of the AC joint so you can return to everyday activities and sports without pain or weakness.

When is surgery needed?

You may be offered AC joint reconstruction if:

• You have a severe AC joint dislocation (grade III or higher)
• Your joint hasn’t healed properly after conservative treatment like rest, physiotherapy, and pain relief
• You have ongoing pain, weakness, or limited shoulder function
• You want to return to high-demand activities or sport and the joint is unstable

Most minor AC joint injuries improve with time and rehabilitation. Surgery is usually only considered if non-surgical treatment doesn’t work or if the injury is more serious from the outset.

What does the surgery involve?

The operation is usually done under general anaesthetic and takes around 1 to 2 hours. There are different techniques, but most aim to stabilise the joint using surgical implants, grafts, or a combination of both. These may include:

• Tightrope technique or suspensory fixation: Small devices and strong sutures are used to hold the bones in the right place.
• Ligament reconstruction: Tendon grafts from your own body or a donor may be used to rebuild the damaged ligaments.
• Bone trimming: In chronic cases, the end of the collarbone may be removed to stop it rubbing and causing pain.

Your surgeon will choose the technique that best suits your injury and lifestyle needs.

Recovery and rehabilitation

After surgery, your arm will be placed in a sling for a few weeks to protect the repair. You’ll start gentle movements early on, followed by a structured physiotherapy programme to rebuild strength and flexibility.

Most people can:

• Return to desk work within 2 to 4 weeks
• Resume light activities at 6 to 8 weeks
• Return to sports or manual work from 3 to 6 months, depending on the level of physical demand

It’s important to follow your rehab plan closely and avoid heavy lifting or contact sports too soon, as this could damage the repair.

Risks and complications

AC joint reconstruction is generally safe, but like all surgery, it carries some risks. These may include:

• Infection
• Bleeding or bruising
• Stiffness or weakness in the shoulder
• Implant or graft failure
• Ongoing pain or tenderness
• Numbness near the surgical scar

Most complications are rare and your surgeon will discuss these with you in detail before the operation.

Will my shoulder go back to normal?

Most people recover well from AC joint reconstruction and are able to return to their usual activities, including sport. Some people may notice slight differences in strength or shoulder appearance, but these usually don’t affect function.

With a successful repair and good rehabilitation, your shoulder should feel more stable and less painful, helping you get back to the things you enjoy.

Why choose Midlands Orthopaedic Clinic?

At Midlands Orthopaedic Clinic, you’ll be treated by leading specialists in shoulder and upper limb surgery. Our consultants have extensive experience in managing complex AC joint injuries and perform the latest minimally invasive and reconstructive techniques tailored to your needs.

We offer rapid access to assessment, on-site diagnostics, and personalised treatment plans — all delivered in a friendly, professional setting. Whether you’re an athlete looking to return to sport or someone struggling with day-to-day shoulder pain, our team is here to help you recover quickly and safely.

Get in touch

If you’re experiencing shoulder pain or think you may need AC joint reconstruction, contact Midlands Orthopaedic Clinic today to book a consultation with one of our expert shoulder surgeons. We’re here to guide you every step of the way.